Individual
KELLY D FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
5150 VILLAGE SQUARE DRIVE, PADUCAH, KY 42001-9060
(270) 415-9575
(270) 415-9576
Mailing address
PO BOX 7208, PADUCAH, KY 42002-7208
(270) 415-9575
(270) 415-9576
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4806P
KY
Other
Enumeration date
05/19/2006
Last updated
08/19/2008
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