Basic Information
Provider Information
NPI: 1033512124
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PENN
FirstName: LINDSAY
MiddleName: ATHERTON
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ATHERTON
OtherFirstName: LINDSAY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PA-C
OtherLastNameType: 1
Mailing Information
Address1: 800 ROSE ST
Address2: UK - DIVISION OF HOSPITAL MEDICINE
City: LEXINGTON
State: KY
PostalCode: 405360298
CountryCode: US
TelephoneNumber: 8593236047
FaxNumber: 8592573873
Practice Location
Address1: 800 ROSE ST
Address2: UK - DIVISION OF HOSPITAL MEDICINE
City: LEXINGTON
State: KY
PostalCode: 405360298
CountryCode: US
TelephoneNumber: 8593236047
FaxNumber: 8592573873
Other Information
ProviderEnumerationDate: 10/02/2014
LastUpdateDate: 12/19/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA1911KYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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