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Individual

KELSEY ANN GROTHOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1000 BRECKENRIDGE ST STE 401, OWENSBORO, KY 42303-0878
(270) 688-4401
(270) 688-4409
Mailing address
9510 ORMSBY STATION RD STE 100, LOUISVILLE, KY 40223-4082
(502) 327-9100
(855) 632-8329

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1137632
KY
363LF0000X
Family Nurse Practitioner
Primary
3013956
KY
363LF0000X
Family Nurse Practitioner
71009609
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14559089
CAQH
Enumeration date
10/09/2019
Last updated
12/20/2023
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