LORA MUTISO APRN NPI 1689795536

NPI Information

  • NPI: 1689795536
  • Provider Name: LORA MUTISO, APRN
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1306 VERSAILLES RD
    SUITE 120
    LEXINGTON, KY
    ZIP 40504
  • Phone: (859) 259-2635

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NPI Details

Lora Mutiso, APRN is a psychiatric/mental health nurse practitioner in Lexington, KY with 22 years of experience. Lora Mutiso, APRN NPI is 1689795536. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1306 VERSAILLES RD
SUITE 120
LEXINGTON, KY
ZIP 40504-796
Phone: (859) 259-2635
Fax: (859) 254-7874

The NPI 1689795536 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/2/2007 and was last updated on 4/23/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner4380PKENTUCKYNo
2363LP0808XNurse PractitionerPsychiatric/Mental Health3004380KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17100384290MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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