Individual
MS. KELLY SHROUT RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1101 VETERANS DR, LEXINGTON, KY 40502-2235
(859) 233-4511
Mailing address
1038 RAINTREE DR, RICHMOND, KY 40475-3003
(859) 358-2771
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007554
KY
Other
Enumeration date
10/16/2012
Last updated
11/12/2024
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