Provider Demographics
NPI:1841567237
Name:CAPPS, CHRISTY MILLS
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:MILLS
Last Name:CAPPS
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 1:164 WELLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-9422
Mailing Address - Country:US
Mailing Address - Phone:606-269-8873
Mailing Address - Fax:
Practice Address - Street 1:164 WELLINGTON DR
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-9422
Practice Address - Country:US
Practice Address - Phone:606-269-8873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY200306481174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist