Provider Demographics
NPI:1730858416
Name:SENTELLE, MICHELLE Y (APRN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:Y
Last Name:SENTELLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 REGENCY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2954
Mailing Address - Country:US
Mailing Address - Phone:859-278-1316
Mailing Address - Fax:859-276-3847
Practice Address - Street 1:2416 REGENCY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2954
Practice Address - Country:US
Practice Address - Phone:859-278-1316
Practice Address - Fax:859-276-3847
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1135087163W00000X
KY3016735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse