Organization
PRIMARY EXPRESS CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACE KELLY FNP-C (OWNER/CLINICAL DIRECTOR)
(502) 415-3943
Entity
Organization
Contact information
Practice address
5908 PRESTON HWY, LOUISVILLE, KY 40219-1316
(502) 290-5871
Mailing address
109 WILDWOOD LN, LOUISVILLE, KY 40223-2851
(502) 415-3943
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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