Individual
KACEY NICELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
145 NEWCOMB AVE, MOUNT VERNON, KY 40456-2728
(606) 256-2195
(606) 256-3947
Mailing address
145 NEWCOMB AVE, MOUNT VERNON, KY 40456-2728
(606) 256-2195
(606) 256-3947
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3011645
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3011645
STATE LICENSE
KY
Enumeration date
08/14/2017
Last updated
07/21/2022
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