Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 3008169 | KY |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 3008169 | KY |
NPI | 1043643869 |
---|---|
Provider Name | Kelly J Meyers |
First Address | Lexington, KY 40536-0001 |
Second Address | Lexington, KY 40536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2013 |
Last Update Date | 14/05/2018 |