Provider Demographics
NPI:1396907358
Name:CRESS, DAVID LEE (OTR/L)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEE
Last Name:CRESS
Suffix:
Gender:M
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 1:412 SEA BISCUIT DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-9026
Mailing Address - Country:US
Mailing Address - Phone:859-236-7040
Mailing Address - Fax:
Practice Address - Street 1:853 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-1260
Practice Address - Country:US
Practice Address - Phone:859-734-7791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR1455314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY$$$$$$$$$OtherMPI