Lisa Stabe

Individual provider Active NPI Massage Therapist · Fern Creek, KY

NPI 1194004549 · NPPES record last updated Aug 16, 2011

Key facts

NPI
1194004549
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
2365 (KY)
Practice address
8015 Bardstown Rd
Fern Creek, KY 40291-3439
Phone
(502) 239-3993
Fax
(502) 239-3939
NPI assigned
Aug 16, 2011
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2365KYMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 2365 KY Yes

Addresses

Primary practice location

8015 Bardstown Rd
Fern Creek, KY 40291-3439

Mailing address

8015 Bardstown Rd
Fern Creek, KY 40291-3439
Phone (502) 239-3993

Other providers in Fern Creek, KY

All providers in Fern Creek, KY · Massage Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.