Jennifer Anne Caudill, LMT
Individual provider Active NPI Massage Therapist · Salt Lick, KY
NPI 1083925879 · NPPES record last updated Aug 19, 2013
Key facts
- NPI
- 1083925879
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- KY-1953 (KY)
- Practice address
- 440 Main Street Lot 10
Salt Lick, KY 40371-0119 - Phone
- (859) 404-9529
- NPI assigned
- Jun 25, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY-1953 | KY | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | KY-1953 | KY | Yes |
Addresses
Primary practice location
440 Main Street Lot 10
Salt Lick, KY 40371-0119
Mailing address
PO Box 119
Salt Lick, KY 40371-0119
Phone (859) 404-9529
Other providers in Salt Lick, KY
All providers in Salt Lick, KY · Massage Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.