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General NPI Number Information
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NPI Number | 1548131469
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Entity Type | Individual
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Provider Name | KEELIE TILLETT APRN
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Gender | Female
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 151 E BROADWAY ST
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City | EMINENCE
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State | KY
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Zip | 40019-1149
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Country | US
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Telephone | 502-845-6288
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Fax | 502-845-1000
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Provider Business Mailing Address
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Address Line | 5069 TEALWOOD DR
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City | SHELBYVILLE
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State | KY
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Zip | 40065-6355
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Country | US
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Telephone | 502-220-2661
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4044338
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License Number State | KY
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