| Positive Connections, Pllc | |
|
6813 W Highway 22 Crestwood KY 40014-7007 | |
| (502) 243-2622 | |
| (502) 243-2692 |
| Full Name | Positive Connections, Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 6813 W Highway 22, Crestwood, Kentucky |
| Authorized Official Name and Position | Julia E. Pennington (MEMBER/OWNER) |
| Authorized Official Contact | 5022432622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive Connections, Pllc 6813 W Highway 22 Crestwood KY 40014-7007 Ph: (502) 243-2622 | Positive Connections, Pllc 6813 W Highway 22 Crestwood KY 40014-7007 Ph: (502) 243-2622 |
| NPI Number | 1861632622 |
|---|---|
| Provider Enumeration Date | 03/05/2009 |
| Last Update Date | 09/01/2015 |
| Medicare PECOS PAC ID | 1850440074 |
|---|---|
| Medicare Enrollment ID | O20090519000200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861632622 | NPI | - | NPPES |
| 000000609052 | Other | ANTHEM PIN | |
| D081722 | Other | VALUEOPTIONS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 3004525 (Kentucky) | Primary |
| Provider Name | Elizabeth Behr Runyon |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1780603241 PECOS PAC ID: 0941257711 Enrollment ID: I20050404000846 |
| Provider Name | Julia Elizabeth Pennington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114188281 PECOS PAC ID: 9739238957 Enrollment ID: I20100304000037 |
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