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722 W Byers Ave Owensboro KY 42303-6330 | |
| (270) 478-5040 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 722 W Byers Ave, Owensboro, Kentucky |
| Authorized Official Name and Position | Ernest Daniel Mills (OWNER) |
| Authorized Official Contact | 2704785040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
722 W Byers Ave Owensboro KY 42303-6330 Ph: (270) 478-5040 | 722 W Byers Ave Owensboro KY 42303-6330 Ph: (270) 478-5040 |
| NPI Number | 1972140911 |
|---|---|
| Provider Enumeration Date | 12/10/2019 |
| Last Update Date | 01/12/2021 |
| Medicare PECOS PAC ID | 2466888391 |
|---|---|
| Medicare Enrollment ID | O20200212000990 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972140911 | NPI | - | NPPES |
| 7100655250 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Jackqueline Sue Easler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619489689 PECOS PAC ID: 4688931975 Enrollment ID: I20171121001991 |
| Provider Name | Jamie E Durham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780216721 PECOS PAC ID: 7214364595 Enrollment ID: I20200226001551 |
| Provider Name | Angela Coffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811503410 PECOS PAC ID: 6406267707 Enrollment ID: I20201117002321 |
| Provider Name | Jennifer A Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396490934 PECOS PAC ID: 1658747449 Enrollment ID: I20221019001851 |
Jones Medical Corp Dba Bridgewater Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 750 Salem Drive, Owensboro, KY 42303 Phone: 270-686-8008 Fax: 270-686-8066 | |
Choice Care Associates, Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Breckenridge St, Suite 400, Owensboro, KY 42303 Phone: 270-688-0900 Fax: 207-926-7488 | |
Randy L Wolfe, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 Triplett St, Owensboro, KY 42303 Phone: 270-688-4325 | |
Robert C Dalzell,md Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2816 Veach Rd, Owensboro, KY 42303 Phone: 270-926-2929 Fax: 270-683-3290 |