Individual
MRS. KELLI STEVENS HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-7001
(859) 257-1000
(859) 257-3347
Mailing address
1761 BEACON HILL RD, LEXINGTON, KY 40504-2212
(859) 618-4930
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3014467
KY
363LF0000X
Family Nurse Practitioner
Primary
3014467
KY
Other
Enumeration date
11/17/2021
Last updated
12/22/2021
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