Individual
DR. KELLY N PRINGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 MALLARD CREEK RD STE 395, LOUISVILLE, KY 40207-5167
(502) 895-9421
(502) 899-5762
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 212-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35844
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000533403
ANTHEM - CMA
IN
01
—
090052
SIHO - CMA
IN
05
—
200878520
—
IN
01
—
50015980
PASSPORT - CMA
IN
Enumeration date
09/23/2005
Last updated
05/20/2022
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