Individual
AMANDA CATHERINE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
740 S LIMESTONE STE B101, LEXINGTON, KY 40536-1140
(859) 323-5661
(859) 323-6411
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2743
KY
363AM0700X
Medical Physician Assistant
PA2743
KY
363AM0700X
Medical Physician Assistant
TC016
KY
363AS0400X
Surgical Physician Assistant
PA2743
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100636790
—
KY
Enumeration date
02/08/2021
Last updated
06/29/2023
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