Healthcare Provider Details

I. General information

NPI: 1437203395
Provider Name (Legal Business Name): CHRISTINE ANN DUTTLINGER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 VETERANS DR RM B502D
LEXINGTON KY
40502-2235
US

IV. Provider business mailing address

1101 VETERANS DR RM B502D
LEXINGTON KY
40502-2235
US

V. Phone/Fax

Practice location:
  • Phone: 859-233-4511
  • Fax: 859-281-4963
Mailing address:
  • Phone: 859-233-4511
  • Fax: 859-281-4963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA777
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: