| Kellie Richelle Sparks, APRN | |
|
645 Interstate Dr, Grayson, KY 41143-1704 | |
| (606) 474-0669 | |
| Not Available |
| Full Name | Kellie Richelle Sparks |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 8 Years |
| Location | 645 Interstate Dr, Grayson, Kentucky |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083062988 | NPI | - | NPPES |
| 7100419400 | Medicaid | KY | |
| 0170248 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 3010258 (Kentucky) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| King's Daughters' Medical Center | Ashland, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lewis County Primary Care Center Inc | 1153311774 | 79 |
| Entity Name | Ashland Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053748913 PECOS PAC ID: 7719882521 Enrollment ID: O20031204000877 |
| Entity Name | Lewis County Primary Care Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457303802 PECOS PAC ID: 1153311774 Enrollment ID: O20040515000278 |
| Mailing Address | Practice Location Address |
|---|---|
| Kellie Richelle Sparks, APRN Po Box 550, Vanceburg, KY 41179-0550 Ph: (606) 796-3029 | Kellie Richelle Sparks, APRN 645 Interstate Dr, Grayson, KY 41143-1704 Ph: (606) 474-0669 |
Maria Baker Sargent, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 Bellefonte Dr, Grayson, KY 41143 Phone: 606-474-0669 | |
Brittany Gene Bond, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 Bellefonte Dr, Grayson, KY 41143 Phone: 606-475-5505 Fax: 606-475-5506 | |
Mrs. Shelby Anne Hill, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 645 Interstate Dr, Grayson, KY 41143 Phone: 606-474-0669 | |
Maryellen Tussey, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 207 N Carol Malone Blvd Ste 3, Grayson, KY 41143 Phone: 606-225-8200 Fax: 888-606-7354 | |
Tori Scott, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 609 N Carol Malone Blvd Ste 100, Grayson, KY 41143 Phone: 606-475-0152 Fax: 606-474-4240 | |
Stacy Holley, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 107 E Main St, Grayson, KY 41143 Phone: 606-474-0244 Fax: 606-474-0412 |