MRS. TANYA EZELL CROCKETT (NPI# 1740564954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740564954 |
| Entity Type | Individual |
| Full Name | MRS. TANYA EZELL CROCKETT |
| Credential | APRN, CPNP-PC |
| Practice Address |
496 Southland Dr Lexington KY 40503-1827 |
| Mailing Address |
608 Brasher St Wilmore KY 40390-1059 |
| Practice Telephone | 8592882425 |
| Practice Fax Number | 8597213918 |
| Mailing Telephone | 8598589154 |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2019-05-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
3007181 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100197040 | 05 |
| Street Address |
496 SOUTHLAND DR |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40503-1827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467445056 | Shelagh Marie Cassidy | Social Worker | 496 Southland Dr, Lexington, KY 40503-1827 | 2005-08-30 |
| 1871108100 | Kayla Putton Bowling | Nurse Practitioner | 496 Southland Dr, Lexington, KY 40503-1827 | 2020-09-14 |
| 1023580834 | Meagan Gee | Social Worker | 496 Southland Dr, Lexington, KY 40503-1827 | 2018-12-19 |
| 1558899799 | Christopher Casterline | Dentist | 496 Southland Dr, Lexington, KY 40503 | 2017-06-01 |
| 1548798309 | Lindsey Elora Mcalpine | Nurse Practitioner | 496 Southland Dr, Lexington, KY 40503 | 2017-05-24 |
| 1861840795 | Healthfirst Bluegrass Inc | Clinic/Center | 496 Southland Dr, Lexington, KY 40503-1827 | 2016-06-01 |
| 1235509761 | Lauren Bauer | Nurse Practitioner | 496 Southland Dr, Lexington, KY 40503-1827 | 2015-09-27 |
| 1588031397 | Katherine Taylor Bentsen | Social Worker | 496 Southland Dr, Lexington, KY 40503 | 2015-08-27 |
| 1285017327 | Jeffrey R Kovarik | Dentist | 496 Southland Dr, Lexington, KY 40503-1827 | 2015-07-07 |
| 1235522475 | Victoria Nash | Nurse Practitioner | 496 Southland Dr, Lexington, KY 40503 | 2015-03-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548804743 | Lucas Kyle Brothers | Occupational Therapist | 401 Lewis Hargett Cir #120, Lexington, KY 40503 | 2019-10-30 |
| 1598322364 | Bobbi Jo Macqueston | Developmental Therapist | 825 Apache Trail, Lexington, KY 40503 | 2019-05-28 |
| 1750846234 | Smart Dental & Hygiene Express | Dentist | 2600 Nicholasville Rd Suite 120, Lexington, KY 40503 | 2019-02-08 |
| 1780148353 | Southland Child, Adult, and Family Counseling | Counselor | 2039 Regency Rd., Ste 1, Lexington, KY 40503 | 2019-01-28 |
| 1073093357 | Amanda Zachem | Nurse Practitioner | 1780 Nicholasville Rd., Suite #203, Lexington, KY 40503 | 2018-08-16 |
| 1083101240 | Man O War Urgent Care LLC | Nurse Practitioner | 4097 Nichols Park Dr Ste 108, Lexington, KY 40503 | 2018-04-13 |
| 1255833737 | Bennett Gatto | Physical Therapist | 3882 Mall Road, Lexington, KY 40503 | 2018-03-01 |
| 1528566114 | Alteri, LLC | Counselor | 1517 Nicholasville Rd Ste 402, Lexington, KY 40503 | 2018-01-29 |
| 1245748235 | Sherry Kay Adkins | Registered Nurse | Baptist Health Lexington 1740 Nicholasville Road, Diabetes Education, Lexington, KY 40503 | 2018-01-12 |
| 1003334780 | Martin Bennett Hundley | Counselor | 274 Southland Dr # 204, Lexington, KY 40503 | 2017-09-01 |
| Find all providers in zip 40503 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487190112 | Kendra D Grissom | Nurse Practitioner | 10777 Highway 412 W, Lexington, TN 38351-6283 | 2017-01-19 |
| 1386194447 | Morgan Chojnacki | Nurse Practitioner | Kentucky Clinic Pediatric High Bmi Clinic, 740 S. Limestone 2nd Floor Wing D, Lexington, KY 40536 | 2016-10-12 |
| 1811374887 | Hannah Lynn Puntney | Nurse Practitioner | 800 Rose St. Ms 235, Lexington, KY 40536 | 2015-04-29 |
| 1508294000 | Kelly Caroline Nelson | Nurse Practitioner | 740 S Limestone Rm J442, Lexington, KY 40536-0001 | 2013-10-18 |
| 1891097580 | Jocelyn Miller Snider | Nurse Practitioner | 1223 S Lake Dr, Lexington, SC 29073-6889 | 2010-12-01 |
| 1467789974 | Amanda Faith Dressman | Nurse Practitioner | 1780 Nicholasville Rd Ste 301, Lexington, KY 40503-1413 | 2009-11-05 |
| 1932378593 | Katherine Elaine Fletcher | Nurse Practitioner | 1135 Red Mile Pl, Lexington, KY 40504-1172 | 2008-02-27 |
| 1578602959 | Kate Mcalister Grap | Nurse Practitioner | 1113 Centre Pkwy, Lexington, KY 40517-3208 | 2007-02-05 |
| 1598804973 | Carol Ennis Martin | Nurse Practitioner | The Kentucky Clinic Wing D J252, 740 S. Limestone, Lexington, KY 40536 | 2007-02-05 |
| 1740350347 | Christina Knox Conley | Nurse Practitioner | 800 Rose St Ste C400, Lexington, KY 40536-1835 | 2006-11-09 |
| Find all providers in LEXINGTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.