Provider Demographics
NPI:1932404605
Name:GATLIFF, NOVA ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:NOVA
Middle Name:ELIZABETH
Last Name:GATLIFF
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:NOVA
Other - Middle Name:GATLIFF
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:160 NORTH EAGLE CREEK DRIVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509
Mailing Address - Country:US
Mailing Address - Phone:859-258-5220
Mailing Address - Fax:859-258-5405
Practice Address - Street 1:160 N EAGLE CREEK DR STE 400
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2124
Practice Address - Country:US
Practice Address - Phone:859-258-5220
Practice Address - Fax:859-258-5405
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1076859163W00000X
KY3004231207VM0101X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100149970Medicaid
KY7100149970Medicaid