Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2006DT | KY |
NPI | 1013242106 |
---|---|
Provider Name | Dr. Eilene Eugenio Kinzer |
First Address | Pikeville, KY 41501-9118 |
Second Address | Pikeville, KY 41501-9118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2009 |
Last Update Date | 16/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201080570 | (05) | VA |
7100397540 | (05) | KY |