| Bluegrass Vein Clinic | |
|
201 Professional Park Dr Glasgow KY 42141-3486 | |
| (270) 392-3661 | |
| (580) 297-9310 |
| Full Name | Bluegrass Vein Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 201 Professional Park Dr, Glasgow, Kentucky |
| Authorized Official Name and Position | Julie Schoenbaechler (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5022208437 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluegrass Vein Clinic 106 Trigg Ct Glasgow KY 42141-2252 Ph: (270) 392-3661 | Bluegrass Vein Clinic 201 Professional Park Dr Glasgow KY 42141-3486 Ph: (270) 392-3661 |
| NPI Number | 1508483512 |
|---|---|
| Provider Enumeration Date | 06/25/2020 |
| Last Update Date | 11/18/2021 |
| Certification Date | 11/18/2021 |
| Medicare PECOS PAC ID | 0547685471 |
|---|---|
| Medicare Enrollment ID | O20200810000307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508483512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Heather J Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801145230 PECOS PAC ID: 4789833765 Enrollment ID: I20160119000287 |
| Provider Name | James Isenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003281627 PECOS PAC ID: 9638471816 Enrollment ID: I20161007000993 |
| Provider Name | Kayla Johnson Kuzma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942793096 PECOS PAC ID: 8527319482 Enrollment ID: I20180917001735 |
| Provider Name | Paige Pauley |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1437516101 PECOS PAC ID: 7113384850 Enrollment ID: I20230612000948 |
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