Provider Demographics
NPI:1265673149
Name:FRENCH, CONSTANCE KAY
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:KAY
Last Name:FRENCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8255 KY HIGHWAY 1247
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-9209
Mailing Address - Country:US
Mailing Address - Phone:606-365-7153
Mailing Address - Fax:
Practice Address - Street 1:8255 KY HIGHWAY 1247
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-9209
Practice Address - Country:US
Practice Address - Phone:606-365-7153
Practice Address - Fax:606-365-7153
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist