Etheridge, Destiny

Etheridge, Destiny is an individual health care provider with primary practice located at 1720 W Broadway Ste 107 , Louisville KY 40203-3607. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Etheridge, Destiny can be contacted via phone (502) 340-5900.

Contact Information

Primary practice address
1720 W Broadway Ste 107 Louisville KY 40203-3607
Phone: (502) 340-5900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X TP282 Kentucky
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 55932 Kentucky
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 55932 Kentucky

Profile Details

NPI number 1871099002
LBN Legal business name Etheridge, Destiny
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2018
Last updated Aug 8th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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