Individual
KELLY RAE GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-5689
Mailing address
13402 CREEKVIEW RD, PROSPECT, KY 40059-9028
(502) 396-0237
(502) 384-8670
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3015261
KY
Other
Enumeration date
10/22/2020
Last updated
11/17/2025
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