Healthcare Provider Details

I. General information

NPI: 1144193046
Provider Name (Legal Business Name): KEILEIGH GREGORY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 S MAIN ST
FRANKLIN KY
42134-2322
US

IV. Provider business mailing address

201 PARK ST
BOWLING GREEN KY
42101-1708
US

V. Phone/Fax

Practice location:
  • Phone: 270-598-9595
  • Fax: 270-598-9590
Mailing address:
  • Phone: 270-598-9595
  • Fax: 270-598-9590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4046381
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: