Basic Information
| Provider Information | |||||||||
| NPI: | 1821039215 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAIN | ||||||||
| FirstName: | KRISTINE | ||||||||
| MiddleName: | YODER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E LIBERTY ST | ||||||||
| Address2: | SUITE 800 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402021434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6069330780 | ||||||||
| FaxNumber: | 6063307825 | ||||||||
| Practice Location | |||||||||
| Address1: | 170 N EAGLE CREEK DR | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405099087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592630141 | ||||||||
| FaxNumber: | 8592638669 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 09/01/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VM0101X | 39833 | KY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 50028316 | 01 | NMFMS/PHP | OTHER | 000000657584 | 01 | NMF/ANTHEM | OTHER | 000000657584 | 01 | NMFMS/ANTHEM | OTHER | 000052153G | 01 | NMF/HUMANA | OTHER | 000052153G | 01 | NMFMS/HUMANA | OTHER | 3400434 | 01 | NMFMS/CIGNA | OTHER | 64106032 | 05 | KY | MEDICAID | 113348 | 01 | NMF/SIHO | OTHER | 200843980 | 05 | IN | MEDICAID |