Organization
NEUROSCIENCE ASSOCIATES OF NORTHERN KENTUCKY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN B KELLY MD (PRESIDENT)
(859) 341-3412
Entity
Organization
Contact information
Practice address
2845 CHANCELLOR DR, CRESTVIEW HILLS, KY 41017-3452
(859) 341-3412
(859) 341-3171
Mailing address
2845 CHANCELLOR DR, CRESTVIEW HILLS, KY 41017-3418
(859) 341-3412
(859) 341-3171
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
1096049
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6081204000
DOL
KY
05
—
65933947
—
KY
01
—
DF1983
RAILROAD MEDICARE
KY
Enumeration date
07/20/2005
Last updated
01/06/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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