Healthcare Provider Details

I. General information

NPI: 1083319164
Provider Name (Legal Business Name): FAITH LOUTHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 KY HIGHWAY 36 E STE G3
CYNTHIANA KY
41031-7492
US

IV. Provider business mailing address

1210 KY HIGHWAY 36 E
CYNTHIANA KY
41031-7490
US

V. Phone/Fax

Practice location:
  • Phone: 859-298-2888
  • Fax:
Mailing address:
  • Phone:
  • Fax: 859-234-8699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number61706
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: