| Etown Family Practice | |
|
1239 Woodland Dr Suite 105 Elizabethtown KY 42701-2770 | |
| (270) 900-0192 | |
| Not Available |
| Full Name | Etown Family Practice |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 1239 Woodland Dr, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Gwen Thomas (APRN) |
| Authorized Official Contact | 2709000192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Etown Family Practice 1239 Woodland Dr Ste 105 Elizabethtown KY 42701-2770 Ph: (270) 900-0192 | Etown Family Practice 1239 Woodland Dr Suite 105 Elizabethtown KY 42701-2770 Ph: (270) 900-0192 |
| NPI Number | 1922443480 |
|---|---|
| Provider Enumeration Date | 05/09/2013 |
| Last Update Date | 12/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922443480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | KY3007643 (Kentucky) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 3007643 (Kentucky) | Primary |
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