Provider Demographics
NPI:1467493882
Name:DENHAM, GAYLE (PHD, PMHNP, BC)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:
Last Name:DENHAM
Suffix:
Gender:F
Credentials:PHD, PMHNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1472 GREASY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-7714
Mailing Address - Country:US
Mailing Address - Phone:606-669-1507
Mailing Address - Fax:606-365-7001
Practice Address - Street 1:207 E MAIN ST
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-1339
Practice Address - Country:US
Practice Address - Phone:606-365-7007
Practice Address - Fax:606-365-7001
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2829P363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2029184OtherCIGNA
KY000000314776OtherANTHEM BC BS
KY78028297Medicaid
KY1210159OtherCHA
KY78028297Medicaid
KYNP00031Medicare PIN