Lisa Michelle Keown, ARNP

Individual provider Active NPI Adult Health Nurse Practitioner · Taylorsville, KY

NPI 1184698193 · NPPES record last updated Feb 26, 2010

Key facts

NPI
1184698193
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
3968P (KY)
Practice address
851 McIntosh Dr
Taylorsville, KY 40071-8407
Phone
(502) 477-2911
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 3

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3968PKYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premiere Providers PLLC Past
since Nov 20, 2004
Accepting new patients
Physicians Geriatric Health Services Inc Past Accepting new patients
Integritas of Kentucky, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3968P KY Yes

Addresses

Primary practice location

851 McIntosh Dr
Taylorsville, KY 40071-8407

Mailing address

851 McIntosh Dr
Taylorsville, KY 40071-8407
Phone (502) 477-2911

Other identifiers

IdentifierTypeStateIssuer
78903952MedicaidKY

Other providers in Taylorsville, KY

All providers in Taylorsville, KY · Adult Health Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.