Angela Michele Buck, APRN

Individual provider Active NPI Family Nurse Practitioner · Lawrenceburg, KY

NPI 1104076371 · NPPES record last updated Nov 30, 2018

Key facts

NPI
1104076371
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
5649P (KY)
Practice address
1100 Glensboro Rd Ste 8
Lawrenceburg, KY 40342-9084
Phone
(502) 604-1129
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5649PKYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Primary Care LLC Family Past
since Jan 5, 2004
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5649P KY Yes

Addresses

Primary practice location

1100 Glensboro Rd Ste 8
Lawrenceburg, KY 40342-9084

Mailing address

1339 Lock Rd
Lawrenceburg, KY 40342-9696
Phone (502) 604-1129

Other practice location 1

303 S 4th St
Danville, KY 40422-2091
Phone (859) 236-1080

Other identifiers

IdentifierTypeStateIssuer
3005649OtherKYAPRN KENTUCKY BOARD OF NURSING LICENSE
7100058790MedicaidKY
1091915OtherKYRN LICENSE

Other names

  • Angela Michele Melton Former name

Other providers in Lawrenceburg, KY

All providers in Lawrenceburg, KY · Family Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.