| Lisa Mallard, ARNP, CNM | |
|
170 N Eagle Creek Dr Ste 104, Lexington, KY 40509-9087 | |
| (859) 967-5848 | |
| (859) 967-5473 |
| Full Name | Lisa Mallard |
|---|---|
| Gender | Female |
| Speciality | Advanced Practice Midwife |
| Location | 170 N Eagle Creek Dr Ste 104, Lexington, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891847869 | NPI | - | NPPES |
| 7100503870 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367A00000X | Advanced Practice Midwife | ARNP 2157582 (Florida) | Secondary |
| 367A00000X | Advanced Practice Midwife | 3009349 (Kentucky) | Primary |
| Entity Name | Kentuckyone Health Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104875970 PECOS PAC ID: 8820993702 Enrollment ID: O20031204000080 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Mallard, ARNP, CNM Po Box 936, London, KY 40743-0936 Ph: (606) 330-7835 | Lisa Mallard, ARNP, CNM 170 N Eagle Creek Dr Ste 104, Lexington, KY 40509-9087 Ph: (859) 967-5848 |
Mrs. Gayla Sholey, Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 141 N Eagle Creek Dr Ste 200, Lexington, KY 40509 Phone: 859-323-9897 | |
Dolores Polito, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 141 N Eagle Creek Dr, Suite 200, Lexington, KY 40509 Phone: 859-338-8268 | |
Joanne Burris, APRN, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 217 Elm Tree Ln, Lexington, KY 40507 Phone: 859-218-2810 | |
Courtney L Ellis, CNM, APRN Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 1720 Nicholasville Rd Ste 702, Lexington, KY 40503 Phone: 859-264-8811 Fax: 859-264-8822 | |
Amy Maynard, APRN, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 151 N Eagle Creek Dr Ste 320, Lexington, KY 40509 Phone: 859-523-2526 Fax: 859-523-2532 | |
Laure Ann Schadler, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 1720 Nicholasville Rd, Suite 702, Lexington, KY 40503 Phone: 859-264-8811 Fax: 859-264-8822 | |
Megan Lynn Sharp, CNM, APRN Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 141 N Eagle Creek Dr, Ste 200, Lexington, KY 40509 Phone: 859-323-9897 Fax: 859-257-0629 |