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1740564954
TANYA EZELL CROCKETT
LEXINGTON, KY
NPI
1740564954
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: KY 3007181)
Enumeration Date
2011-10-06
Last Update Date
2019-05-22
Business Address
Mrs. TANYA EZELL CROCKETT APRN, CPNP-PC
496 SOUTHLAND DR
LEXINGTON, KY 40503-1827
Phone number: 859-288-2425
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Mailing Address
Mrs. TANYA EZELL CROCKETT APRN, CPNP-PC
608 BRASHER ST
WILMORE, KY 40390-1059
Phone number: 859-858-9154
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