Individual
MS. KELLEY R KIESLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3900 KRESGE WAY STE 51, LOUISVILLE, KY 40207-4683
(502) 259-5955
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5753
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3004367
KY
363L00000X
Nurse Practitioner
71001828A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200499170
—
IN
05
—
78013224
—
KY
01
—
P00263361
RR MCR
KY
Enumeration date
10/04/2005
Last updated
12/07/2020
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