Individual
ERIKA W KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
404 STEVE DRIVE, RUSSELL SPRINGS, KY 42642-4622
(270) 866-3161
(270) 866-3163
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 858-6655
(270) 858-4607
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04297
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14562084
CAQH
—
05
—
7100584270
—
KY
Enumeration date
03/18/2016
Last updated
07/18/2023
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