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General NPI Number Information
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NPI Number | 1063433324
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Entity Type | Individual
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Provider Name | KELLYE NICHOL SINGLETARY M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 12730 TOWNEPARK WAY STE 203
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City | LOUISVILLE
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State | KY
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Zip | 40243-2303
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Country | US
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Telephone | 502-632-3500
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Fax | 888-965-1418
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Provider Business Mailing Address
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Address Line | 239 LANSDOWNE CRES
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City | LOUISVILLE
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State | KY
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Zip | 40245-7202
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Country | US
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Telephone | 502-386-5130
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C144091
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | P3451
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 13045-320
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 102918
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 40273
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License Number State | KY
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