Healthcare Provider Details

I. General information

NPI: 1487160297
Provider Name (Legal Business Name): DAVID NJONG CHINDO APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 US HIGHWAY 62 E
CYNTHIANA KY
41031-6701
US

IV. Provider business mailing address

1112 STONECROP DR
LEXINGTON KY
40509-9054
US

V. Phone/Fax

Practice location:
  • Phone: 859-405-0511
  • Fax:
Mailing address:
  • Phone: 240-481-4175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3014208
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number3014208
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2365129
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: