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Individual
DESTINY ETHERIDGE
Active
Individual
DESTINY ETHERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01085265A
IN
207Q00000X
Family Medicine Physician
55932
KY
207Q00000X
Family Medicine Physician
TP282
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
55932
KY
Other
Enumeration date
04/05/2018
Last updated
07/13/2026
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