At Home Visit, Pllc | |
201 E Main St Ste 1 Grayson KY 41143-1303 | |
(606) 475-0014 | |
(833) 944-0284 |
Full Name | At Home Visit, Pllc |
---|---|
Speciality | Nurse Practitioner |
Location | 201 E Main St Ste 1, Grayson, Kentucky |
Authorized Official Name and Position | Nathana D Hall (OWNER) |
Authorized Official Contact | 6064836021 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
At Home Visit, Pllc 201 E Main St Ste 1 Grayson KY 41143-1303 Ph: (606) 475-0014 | At Home Visit, Pllc 201 E Main St Ste 1 Grayson KY 41143-1303 Ph: (606) 475-0014 |
NPI Number | 1629692298 |
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Provider Enumeration Date | 05/30/2020 |
Last Update Date | 08/26/2021 |
Medicare PECOS PAC ID | 0244654093 |
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Medicare Enrollment ID | O20200727002479 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629692298 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Provider Name | Nathana D Hall |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265928766 PECOS PAC ID: 4385070093 Enrollment ID: I20200128002343 |
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