Individual
ELLEN AZUCENA KINCAID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2650 W BROADWAY, LOUISVILLE, KY 40211-1333
(502) 589-8723
(502) 775-5292
Mailing address
1013 HICKORY SWITCH RD, LA GRANGE, KY 40031-8921
(502) 758-0029
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3016416
KY
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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