Healthcare Provider Details

I. General information

NPI: 1417185083
Provider Name (Legal Business Name): CLARICE NICOLE SINN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 VERSAILLES RD
LEXINGTON KY
40504-1405
US

IV. Provider business mailing address

2 GREENWAY PLZ SUITE 300
HOUSTON TX
77046-0297
US

V. Phone/Fax

Practice location:
  • Phone: 859-257-3573
  • Fax: 859-323-0096
Mailing address:
  • Phone: 832-828-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberQ6286
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number05829
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number05829
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: