=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972709434
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTHERN KENTUCKY INDEPENDENT DISTRICT HEALTH DEPARTMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2007
-----------------------------------------------------
Last Update Date | 01/29/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1098 MONMOUTH ST
-----------------------------------------------------
City | NEWPORT
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41071-3384
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-431-1704
-----------------------------------------------------
Fax | 859-655-6386
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8001 VETERANS MEMORIAL DR
-----------------------------------------------------
City | FLORENCE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41042-7526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-341-4264
-----------------------------------------------------
Fax | 859-578-3689
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DISTRICT DIRECTOR OF HEALTH
-----------------------------------------------------
Name | MRS. LYNNE SADDLER
-----------------------------------------------------
Credential | MD, MPH
-----------------------------------------------------
Telephone | 859-363-2059
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------