Provider Demographics
NPI:1902903537
Name:GETZ, LEZLIE (ARNP)
Entity Type:Individual
Prefix:
First Name:LEZLIE
Middle Name:
Last Name:GETZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LEZLIE
Other - Middle Name:
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:302 MICBETH DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-6332
Mailing Address - Country:US
Mailing Address - Phone:270-365-1225
Mailing Address - Fax:270-365-1252
Practice Address - Street 1:302 MICBETH DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:KY
Practice Address - Zip Code:42445-6332
Practice Address - Country:US
Practice Address - Phone:270-365-1225
Practice Address - Fax:270-365-1252
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002222363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2222POtherLICENSE
KY78001179Medicaid
000000044302OtherBCBS PROVIDER NUMBER
S22396Medicare UPIN
0935323Medicare PIN
0903662Medicare PIN
KY500011686Medicare PIN
0902404Medicare PIN
0952009Medicare PIN
0745824Medicare PIN
0683237Medicare PIN
KY2222POtherLICENSE
0935809Medicare PIN
000000044302OtherBCBS PROVIDER NUMBER
KYK067120Medicare PIN
0601434Medicare PIN