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Contact Information

KELLY OBRIEN, PA-C
711 MEDICAL VILLAGE DR
EDGEWOOD, KY41017
 Phone: 859-873-0452
 Fax: 859-578-3800
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KELLY OBRIEN · (Female)

NPI # 1083212344
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 10/09/2020
Last updated 05/23/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • KY License # PA2701
  • KY License # TC966
Hospital affiliation(s)
  • ST ELIZABETH FLORENCE - (Acute Care)
    4900 HOUSTON ROAD
    FLORENCE, KY 41042
  • ST ELIZABETH MEDICAL CENTER NORTH - (Acute Care)
    1 MEDICAL VILLAGE DRIVE
    LAKESIDE PARK, KY 41017
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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