Kelly, Jennifer

Kelly, Jennifer is an individual health care provider with primary practice located at 3841 Ruckriegel Pkwy , Louisville KY 40299-3986. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Kelly, Jennifer can be contacted via phone (502) 791-8700.

Contact Information

Primary practice address
3841 Ruckriegel Pkwy Louisville KY 40299-3986
Phone: (502) 791-8700
Fax: (502) 742-8523
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 3008785 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 3008785 Kentucky

Profile Details

NPI number 1962804880
LBN Legal business name Kelly, Jennifer
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2014
Last updated Oct 23rd, 2020 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1962804880 NPPES
Kentucky MEDICAID 7100365330

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