| Organization Name: | NEUROSCIENCE ASSOCIATES OF NORTHERN KENTUCKY PSC |
| NPI Number: | 1215936240 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN B KELLY (PRESIDENT) |
| Mailing Address: | 2845 Chancellor Dr Crestview Hills |
| State: | KY US |
| Postal Code: | 410173452 |
| Phone Number: | 8593413412 |
| Fax Number: | 8593413171 |
| NPI Enumeration Date: | 07/20/2005 |
| NPI Last Update Date: | 01/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 1096049 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |