| Kaci Lauren Henard, | |
|
2205 Jacksboro Pike, La Follette, TN 37766-2904 | |
| (423) 352-6500 | |
| Not Available |
| Full Name | Kaci Lauren Henard |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 2205 Jacksboro Pike, La Follette, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467111989 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 206383 (Tennessee) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 30910 (Tennessee) | Primary |
| Entity Name | Eastlake Medical, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467992446 PECOS PAC ID: 6901174788 Enrollment ID: O20170620001620 |
| Mailing Address | Practice Location Address |
|---|---|
| Kaci Lauren Henard, 115 W Ash St, La Follette, TN 37766-3511 Ph: () - | Kaci Lauren Henard, 2205 Jacksboro Pike, La Follette, TN 37766-2904 Ph: (423) 352-6500 |
Judith C Bryson, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 905 E Central Ave, La Follette, TN 37766 Phone: 423-907-1600 Fax: 423-907-1646 | |
Daryn Nichole Hatmaker, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2145 Jacksboro Pike, La Follette, TN 37766 Phone: 423-907-1700 Fax: 423-907-1711 | |
Ms. Carol Ann Marshall, APRN BC PSYCH NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 219 North Ave, Ste 201, Healthcare Services Inc, La Follette, TN 37766 Phone: 423-566-1314 Fax: 423-566-2466 | |
Dr. Stephanie Conder, DNP, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 130 Independence Ln, La Follette, TN 37766 Phone: 423-562-1705 Fax: 423-566-3718 | |
Mrs. Debra Verna, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 504 S Tennessee Ave, La Follette, TN 37766 Phone: 865-712-5478 Fax: 423-562-6106 | |
Denise Danielle Chrzanowski, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 130 Independence Ln, La Follette, TN 37766 Phone: 423-562-1705 Fax: 423-566-3718 | |
Laura Beasley Lockett, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 923 E Central Ave, La Follette, TN 37766 Phone: 423-907-1200 Fax: 865-291-3228 |