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Individual

MRS. MARY JULIA KAISER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-5650
(859) 301-6050
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-7210
(859) 301-7216

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3004387
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000348467
ANTHEM
KY
05
78012762
KY
Enumeration date
08/29/2005
Last updated
08/20/2020
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