4th Street Clinic | |
3 E Main St Washington IN 47501-2907 | |
(812) 486-6639 | |
(812) 698-5420 |
Full Name | 4th Street Clinic |
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Speciality | Nurse Practitioner |
Location | 3 E Main St, Washington, Indiana |
Authorized Official Name and Position | Jessica Ann Wright (NP) |
Authorized Official Contact | 8124866639 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4th Street Clinic 3 E Main St Washington IN 47501-2907 Ph: (812) 486-6639 | 4th Street Clinic 3 E Main St Washington IN 47501-2907 Ph: (812) 486-6639 |
NPI Number | 1023778511 |
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Provider Enumeration Date | 12/23/2021 |
Last Update Date | 02/24/2023 |
Medicare PECOS PAC ID | 9739573437 |
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Medicare Enrollment ID | O20220223000332 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023778511 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Provider Name | Sherri Mathies |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497060644 PECOS PAC ID: 1355538067 Enrollment ID: I20101207001086 |
Provider Name | Jessica A Wright |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205351830 PECOS PAC ID: 5890060552 Enrollment ID: I20171005000626 |
Provider Name | Heather Faith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831976547 PECOS PAC ID: 8123472511 Enrollment ID: I20231004001591 |
Provider Name | Tyler Lee White |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003674946 PECOS PAC ID: 1658712872 Enrollment ID: I20240517003155 |
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