Provider Demographics
NPI:1689022139
Name:CASTON, JANIS LEE LYDICK (APRN, DNP)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:LEE LYDICK
Last Name:CASTON
Suffix:
Gender:F
Credentials:APRN, DNP
Other - Prefix:
Other - First Name:JANIS
Other - Middle Name:LYDICK
Other - Last Name:RICKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3361 DOWNING PL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-2108
Mailing Address - Country:US
Mailing Address - Phone:985-285-9984
Mailing Address - Fax:
Practice Address - Street 1:245 FLEMINGSBURG RD STE A340
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-1015
Practice Address - Country:US
Practice Address - Phone:606-207-2931
Practice Address - Fax:606-783-0964
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08749363LF0000X, 363LW0102X
KY3018761363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily