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General NPI Number Information
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NPI Number | 1790396331
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Entity Type | Individual
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Provider Name | KELLEY RACHELLE MCGARVEY APRN
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Gender | Female
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Dates
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Enumeration Date | 08/16/2020
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 1 MEDICAL VILLAGE DR
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City | EDGEWOOD
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State | KY
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Zip | 41017-3403
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Country | US
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Telephone | 859-301-4000
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Fax | 859-301-4001
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Provider Business Mailing Address
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Address Line | PO BOX 636324
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City | CINCINNATI
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State | OH
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Zip | 45263-6324
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Country | US
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Telephone | 859-301-4000
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Fax | 859-301-4001
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71012587A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 3014915
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3014915
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License Number State | KY
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