Individual
DEEPA E. NIDHIRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
439 W WALNUT ST, SUITE 201, DANVILLE, KY 40422-1877
(859) 236-5366
(859) 236-6754
Mailing address
PO BOX 2485, DANVILLE, KY 40423-2485
(859) 236-5366
(859) 236-6754
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
42286
KY
2084N0400X
Neurology Physician
Primary
42286
KY
2084N0600X
Clinical Neurophysiology Physician
42286
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932305778
ANTHEM BCBS
KY
05
—
200934110
—
IN
05
—
7100067620
—
KY
Enumeration date
06/26/2007
Last updated
07/25/2014
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