Provider Demographics
NPI:1659554160
Name:GILPIN, CYNTHIA JOY (DI)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JOY
Last Name:GILPIN
Suffix:
Gender:F
Credentials:DI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 W. SANDSTONE CT.
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004
Mailing Address - Country:US
Mailing Address - Phone:502-350-4084
Mailing Address - Fax:502-350-4084
Practice Address - Street 1:2004 W. SANDSTONE CT.
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004
Practice Address - Country:US
Practice Address - Phone:502-350-4084
Practice Address - Fax:502-350-4084
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-07
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist