Provider Demographics
NPI:1033965371
Name:MCGINNIS, KYNLEE JO HILLARD (DO)
Entity Type:Individual
Prefix:
First Name:KYNLEE
Middle Name:JO HILLARD
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KYNLEE
Other - Middle Name:JO
Other - Last Name:HILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:530 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1675
Mailing Address - Country:US
Mailing Address - Phone:502-852-1732
Mailing Address - Fax:
Practice Address - Street 1:530 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1675
Practice Address - Country:US
Practice Address - Phone:502-852-1732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program