Healthcare Provider Details

I. General information

NPI: 1831756907
Provider Name (Legal Business Name): KIRSI KUIPER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIRSI LANCASTER

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9847 ELIZABETHTOWN RD
BIG CLIFTY KY
42712-5880
US

IV. Provider business mailing address

9847 ELIZABETHTOWN RD
BIG CLIFTY KY
42712-5880
US

V. Phone/Fax

Practice location:
  • Phone: 270-242-2000
  • Fax:
Mailing address:
  • Phone: 270-242-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number59996
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: