Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 46845 | KY |
NPI | 1003102849 |
---|---|
Provider Name | Dr. Kendra Stratton Cloyd |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-1821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 16/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100216160 | (05) | KY |