Stephanie Rae Kelty
Nurse Practitioner - Pediatrics
4123 Dutchmans Ln Ste 301
Louisville
, Kentucky 40207
Stephanie Rae Kelty
Nurse Practitioner - Pediatrics
4123 Dutchmans Ln Ste 301
Louisville
, Kentucky 40207
(502) 272-5116
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About
Features
Specialties
- Nurse Practitioner - Pediatrics
Languages spoken
- English
Location
First Address
- Stephanie Rae Kelty
- Po Box 776351
- Chicago, IL
- Zip : 60677-6351
- Fax : (502) 272-5116
- Phone : (502) 588-9490
Second Address
- Stephanie Rae Kelty
- 4123 Dutchmans Ln Ste 301
- Louisville, KY
- Zip : 40207
- Fax : (502) 896-2527
- Phone : (502) 896-2500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner - Pediatrics | 3012197 | KY |
National Provider Identifier
| NPI | 1003310921 |
|---|---|
| Provider Name | Stephanie Rae Kelty |
| First Address | Chicago, IL 60677-6351 |
| Second Address | Louisville, KY 40207 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/03/2018 |
| Last Update Date | 15/10/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.