Ms Tia Roche Ivory, FNP-C | |
2019a S Henderson Blvd Ste 2, Kilgore, TX 75662-3567 | |
(903) 483-7707 | |
(903) 483-7708 |
Full Name | Ms Tia Roche Ivory |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 2019a S Henderson Blvd Ste 2, Kilgore, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689176885 | NPI | - | NPPES |
8025511 | Other | TX | AETNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | AP136828 (Texas) | Primary |
Entity Name | Marshall Family Practice Associates Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528070414 PECOS PAC ID: 6901803303 Enrollment ID: O20061027000116 |
Mailing Address | Practice Location Address |
---|---|
Ms Tia Roche Ivory, FNP-C 2019a South Henderson Blvd, Suite 2, Kilgore, TX 75662-3915 Ph: (903) 483-7707 | Ms Tia Roche Ivory, FNP-C 2019a S Henderson Blvd Ste 2, Kilgore, TX 75662-3567 Ph: (903) 483-7707 |
Holly Kristina Royer, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1600 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-521-4609 | |
Michelle Britven, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1600 S Henderson Blvd, Kilgore, TX 75662 Phone: 651-399-1235 Fax: 903-367-0300 | |
Jolyn Kaye Hawkins, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1016 N Kilgore St, Kilgore, TX 75662 Phone: 903-522-4199 Fax: 903-522-4015 | |
Tracey Lynn Bruner, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1600 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-475-3474 Fax: 903-367-0300 | |
Mr. Christopher Kirk Bailey, APRN-FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1718 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-983-2110 Fax: 903-984-3783 | |
Heather Jordan, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-215-3149 | |
Valerie Michelle Vaughn-smith, APRN,MSN, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3105 Rockbrook Dr, Kilgore, TX 75662 Phone: 903-812-0684 |