| Jerry Lee Campbell Jr, APRN | |
|
1550 Highway 15 S Ste 240, Jackson, KY 41339-0709 | |
| (606) 272-7533 | |
| (606) 824-5042 |
| Full Name | Jerry Lee Campbell Jr |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Primary Care |
| Location | 1550 Highway 15 S Ste 240, Jackson, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972281715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP2300X | Nurse Practitioner - Primary Care | 4007079 (Kentucky) | Primary |
| Entity Name | County Line Primary Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609378132 PECOS PAC ID: 0547691289 Enrollment ID: O20200512003100 |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry Lee Campbell Jr, APRN 1550 Highway 15 S Ste 240, Jackson, KY 41339-0709 Ph: (606) 272-7533 | Jerry Lee Campbell Jr, APRN 1550 Highway 15 S Ste 240, Jackson, KY 41339-0709 Ph: (606) 272-7533 |
Heather R Banks, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1484 Lakeside Dr, Jackson, KY 41339 Phone: 606-666-9950 Fax: 606-666-9136 | |
Mrs. Edna Elizabeth Williams, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 832 Highway 15 N, Jackson, KY 41339 Phone: 606-666-5142 Fax: 606-666-4172 | |
Brittney Denise Herald, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 540 Jett Dr, Jackson, KY 41339 Phone: 606-666-6000 | |
Rebecca Mae Holbrook-watkins, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 424 Jett Dr, Jackson, KY 41339 Phone: 606-666-6600 Fax: 606-693-0534 | |
Courtney Brooke Addison, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1484 Lakeside Dr, Jackson, KY 41339 Phone: 606-666-9950 Fax: 606-666-9136 | |
Ms. Beverly Dawn Ellis, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1484 Lakeside Drive, Jackson, KY 41339 Phone: 606-666-9950 Fax: 606-666-9136 | |
Jacqueline Campbell, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1550 Highway 15 S Ste 240, Jackson, KY 41339 Phone: 606-824-5037 Fax: 606-824-5042 |