Provider Demographics
NPI:1831395383
Name:NORTHERN KENTUCKY INDEPENDENT DISITRICT HEALTH DEPARTMENT
Entity type:Organization
Organization Name:NORTHERN KENTUCKY INDEPENDENT DISITRICT HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT DIRECTOR HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SADDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:859-341-4264
Mailing Address - Street 1:8001 VETERANS MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-7526
Mailing Address - Country:US
Mailing Address - Phone:859-341-4264
Mailing Address - Fax:859-578-3689
Practice Address - Street 1:234 BARNES RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:KY
Practice Address - Zip Code:41097-9482
Practice Address - Country:US
Practice Address - Phone:859-824-5074
Practice Address - Fax:859-824-3220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY20041018Medicaid