Provider Demographics
NPI:1295935633
Name:STIVERS, DENIECE (OTR/L)
Entity type:Individual
Prefix:
First Name:DENIECE
Middle Name:
Last Name:STIVERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8633
Mailing Address - Country:US
Mailing Address - Phone:859-576-0147
Mailing Address - Fax:859-625-9917
Practice Address - Street 1:157 CARDINAL DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8633
Practice Address - Country:US
Practice Address - Phone:859-576-0147
Practice Address - Fax:859-625-9917
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR1461174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist