Provider Demographics
NPI:1013171289
Name:LANTER, KIMBERLY CRIPE (MA)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CRIPE
Last Name:LANTER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANNE
Other - Last Name:CRIPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2016 INDIAN RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40342-9408
Mailing Address - Country:US
Mailing Address - Phone:502-727-2745
Mailing Address - Fax:
Practice Address - Street 1:2400 EASTPOINT PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4154
Practice Address - Country:US
Practice Address - Phone:502-210-4752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY141373235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist