Individual provider · Type 1 NPI

Anna Elizabeth Detherage

Student in an Organized Health Care Education/Training Program · Lexington, KY

NPI number 1104735505 Active

Practice location

780 Rose St
Lexington, KY 40536-0001

Call (859) 323-6161 Map

Mailing address

3393 Bayberry Dr
Ashland, KY 41102-6698

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1104735505

Anna Elizabeth Detherage's National Provider Identifier is 1104735505, issued on Sep 2, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Lexington, KY. The record was last updated on Sep 2, 2026.