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Individual

MISS SIBYL C CAGATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
3991 DUTCHMANS LN, SUITE 405, LOUISVILLE, KY 40207-4700
(502) 899-3366
(502) 899-3455
Mailing address
PO BOX 776347, CHICAGO, IL 60677-6347
(502) 899-3366
(502) 899-3455

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
3050P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000174112
ANTHEM PROVIDER NO.
KY
01
124095
PASSPORT PROVIDER NO
KY
01
500012702
RAILROAD MEDICARE
KY
05
78003712
KY
Enumeration date
05/12/2006
Last updated
11/01/2018
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