Individual
KELLY BUTLER-VISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
107 S BROADWAY ST, CARLISLE, KY 40311-1150
(859) 289-4124
(859) 289-4126
Mailing address
107 S BROADWAY ST, CARLISLE, KY 40311-1150
(859) 289-4124
(859) 289-4126
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1334
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100123820
—
KY
Enumeration date
12/29/2009
Last updated
02/13/2013
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