Provider Demographics
NPI:1316350762
Name:SINICROPE, KAYLYN DEANNE (MD)
Entity type:Individual
Prefix:DR
First Name:KAYLYN
Middle Name:DEANNE
Last Name:SINICROPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BO776347
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6347
Mailing Address - Country:US
Mailing Address - Phone:502-272-5817
Mailing Address - Fax:
Practice Address - Street 1:676 S FLOYD ST STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1840
Practice Address - Country:US
Practice Address - Phone:502-629-4440
Practice Address - Fax:502-629-4445
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP1082084N0400X
WI714112084N0400X
KY539502084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300038553Medicaid
KY53950OtherSTATE LICENSE
KY7100664960Medicaid