Basic Information
| Provider Information | |||||||||
| NPI: | 1497966477 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEXINGTON WOMENS HEALTH PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1720 NICHOLASVILLE RD | ||||||||
| Address2: | SUITE 702 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405031489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592648811 | ||||||||
| FaxNumber: | 8592648822 | ||||||||
| Practice Location | |||||||||
| Address1: | 1720 NICHOLASVILLE RD. | ||||||||
| Address2: | SUITE 702 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405031489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592648811 | ||||||||
| FaxNumber: | 8592648822 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2007 | ||||||||
| LastUpdateDate: | 02/14/2020 | ||||||||
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| AuthorizedOfficialLastName: | FUSON | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | M.D. / OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8592648811 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 02/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 1863M | KY | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 207VG0400X | 34331 | KY | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 207VM0101X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine | 363A00000X | KY | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LW0102X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 363LX0001X | KY | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | 207V00000X | KY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 7100219270 | 05 | KY | MEDICAID | 7100648270 | 05 | KY | MEDICAID | 7100225080 | 05 | KY | MEDICAID | 7100227330 | 05 | KY | MEDICAID | 7100644830 | 05 | KY | MEDICAID | 7100225090 | 05 | KY | MEDICAID | 7100227300 | 05 | KY | MEDICAID | 7100225030 | 05 | KY | MEDICAID |