Healthcare Provider Details

I. General information

NPI: 1003770611
Provider Name (Legal Business Name): PRIMARY INJURY CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3928 DUTCHMANS LN
LOUISVILLE KY
40207-4702
US

IV. Provider business mailing address

3928 DUTCHMANS LN
LOUISVILLE KY
40207-4702
US

V. Phone/Fax

Practice location:
  • Phone: 502-576-6178
  • Fax: 502-576-7392
Mailing address:
  • Phone: 502-576-6178
  • Fax: 502-576-7392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TRACE KELLY
Title or Position: OWNER
Credential: FNP
Phone: 502-576-6178