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Individual

KAILYN MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2401 TERRA CROSSING BLVD STE 101, LOUISVILLE, KY 40245-5395
(502) 210-4600
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
58943
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100833010
KY
01
K399340
MEDICARE
KY
Enumeration date
03/27/2021
Last updated
10/14/2024
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