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Kellie Richelle Sparks, APRN
Family Nurse Practitioner in Grayson, Kentucky
NPI 1083062988

Kellie Richelle Sparks is a Family Nurse Practitioner based in Vanceburg, KY and is specialized in Family. Kellie Richelle Sparks practices in Grayson, KY and has the professional credentials of APRN. The NPI Number for Kellie Richelle Sparks is 1083062988 and holds a License No. 3010258 (Kentucky).

The current practice location address for Kellie Richelle Sparks is 645 Interstate Dr, Grayson, KY and can be reached out via phone at 606-474-0669.

Location: 645 Interstate Dr, Grayson, KY, 41179-0550
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1083062988
Provider Name
Kellie Richelle Sparks
Credential
APRN
Provider Entity Type
Individual
Gender
Female
Address
645 Interstate Dr, Grayson, KY, 41179-0550
Phone Number
606-474-0669
Fax Number
Provider Enumeration Date
06/01/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7100419400 05 KY
0170248 05 OH
institution
Provider Business Practice Location Address Details
Address
645 Interstate Dr
City
Grayson
State
Kentucky
Zip
41143-1704
Phone Number
606-474-0669
Fax Number
person
Provider Business Mailing Address Details
Address
645 Interstate Dr
City
Grayson
State
Kentucky
Zip
41143-1704
Phone Number
606-474-0669
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
3010258 (Kentucky)
Definition
Definition to come...
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