Provider Demographics
NPI:1356332118
Name:CROSSFIELD, DANNITA (PT)
Entity Type:Individual
Prefix:
First Name:DANNITA
Middle Name:
Last Name:CROSSFIELD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5027 ATWOOD DR STE 2B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8322
Mailing Address - Country:US
Mailing Address - Phone:859-625-0001
Mailing Address - Fax:859-625-1109
Practice Address - Street 1:127 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-3801
Practice Address - Country:US
Practice Address - Phone:859-234-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY002247225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000333709OtherBC FOR HARRISON
KY87001368Medicaid
KYP00467747OtherPALMETTO/ RAILROAD MEDICARE
KYP00467747OtherPALMETTO/ RAILROAD MEDICARE