Individual
KELLY BETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
8033 DIXIE HWY, LOUISVILLE, KY 40258-1344
(502) 899-6150
(502) 891-6368
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-4710
(502) 588-4771
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3011450
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F06172199
AANP CERTIFICATION NUMBER
—
Enumeration date
06/30/2017
Last updated
10/12/2020
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