Basic Information
| Provider Information | |||||||||
| NPI: | 1578602959 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRAP | ||||||||
| FirstName: | KATE | ||||||||
| MiddleName: | MCALISTER | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | APRN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KIRK | ||||||||
| OtherFirstName: | KATE | ||||||||
| OtherMiddleName: | M | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 496 SOUTHLAND DR | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405031827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592882392 | ||||||||
| FaxNumber: | 8597213918 | ||||||||
| Practice Location | |||||||||
| Address1: | 1113 CENTRE PKWY | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405173208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592882425 | ||||||||
| FaxNumber: | 8597213918 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 05/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 3003496 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 78010618 | 05 | KY | MEDICAID | 7203539 | 01 | KY | AETNA | OTHER | 587554 | 01 | KY | ANTHEM | OTHER |