| Jackson Medical Clinic Family Health Care | |
|
1550 Highway 15 S Ste 240 Jackson KY 41339-0709 | |
| (606) 568-1184 | |
| (606) 824-5042 |
| Full Name | Jackson Medical Clinic Family Health Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1550 Highway 15 S Ste 240, Jackson, Kentucky |
| Authorized Official Name and Position | Jessica Ann Neace (APRN) |
| Authorized Official Contact | 6068245037 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Medical Clinic Family Health Care 41 John Maco Dr Jackson KY 41339-6515 Ph: (606) 568-1184 | Jackson Medical Clinic Family Health Care 1550 Highway 15 S Ste 240 Jackson KY 41339-0709 Ph: (606) 568-1184 |
| NPI Number | 1609378132 |
|---|---|
| Provider Enumeration Date | 02/28/2018 |
| Last Update Date | 02/24/2022 |
| Medicare PECOS PAC ID | 0547691289 |
|---|---|
| Medicare Enrollment ID | O20200512003100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609378132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Jessica Ann Neace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710386503 PECOS PAC ID: 2567681612 Enrollment ID: I20140922002665 |
| Provider Name | Melody Brewer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326511601 PECOS PAC ID: 6608207352 Enrollment ID: I20200512003311 |
| Provider Name | Ellen Tebos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720626641 PECOS PAC ID: 8426468455 Enrollment ID: I20201103002345 |
| Provider Name | Madison Trent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841924180 PECOS PAC ID: 1052795432 Enrollment ID: I20220902001587 |
| Provider Name | Kristian Renee Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023773132 PECOS PAC ID: 7113303645 Enrollment ID: I20221006000279 |
| Provider Name | Jerry Lee Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972281715 PECOS PAC ID: 6709154958 Enrollment ID: I20231220003973 |
| Provider Name | Jacqueline Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235909946 PECOS PAC ID: 2062859820 Enrollment ID: I20240328001992 |
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