Provider Demographics
NPI:1720798259
Name:CUNNINGHAM, JENNIFER TRIPP (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:TRIPP
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:TRIPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1085 GREENBRIAR RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40342-9720
Mailing Address - Country:US
Mailing Address - Phone:859-537-2292
Mailing Address - Fax:
Practice Address - Street 1:102 LEONARDWOOD DR APT 143
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-6506
Practice Address - Country:US
Practice Address - Phone:502-783-1556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist