| Brookwell Health Llc - Kentucky | |
|
4071 Tates Creek Centre Dr Lexington KY 40517-3062 | |
| (866) 589-0003 | |
| (844) 309-6361 |
| Full Name | Brookwell Health Llc - Kentucky |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4071 Tates Creek Centre Dr, Lexington, Kentucky |
| Authorized Official Name and Position | Joseph Huntsman (CEO) |
| Authorized Official Contact | 4237367976 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookwell Health Llc - Kentucky 2829 W Andrew Johnson Hwy Morristown TN 37814-3216 Ph: (423) 307-5757 | Brookwell Health Llc - Kentucky 4071 Tates Creek Centre Dr Lexington KY 40517-3062 Ph: (866) 589-0003 |
| NPI Number | 1538889811 |
|---|---|
| Provider Enumeration Date | 08/29/2022 |
| Last Update Date | 07/20/2023 |
| Certification Date | 07/20/2023 |
| Medicare PECOS PAC ID | 2264890870 |
|---|---|
| Medicare Enrollment ID | O20230614000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538889811 | NPI | - | NPPES |
| Provider Name | Melissa P Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821093675 PECOS PAC ID: 3375584113 Enrollment ID: I20070109000488 |
| Provider Name | Deshayna R Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427417963 PECOS PAC ID: 8123325933 Enrollment ID: I20160322002103 |
| Provider Name | Ryann Poerio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508361601 PECOS PAC ID: 1850655697 Enrollment ID: I20180503000781 |
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