| Firefly Health Pllc | |
|
421 N Broadway Portland TN 37148-1750 | |
| (615) 205-2100 | |
| Not Available |
| Full Name | Firefly Health Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 421 N Broadway, Portland, Tennessee |
| Authorized Official Name and Position | Marcus M Min (MD) |
| Authorized Official Contact | 6152052100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Firefly Health Pllc Po Box 39 Portland TN 37148-0039 Ph: (615) 205-2100 | Firefly Health Pllc 421 N Broadway Portland TN 37148-1750 Ph: (615) 205-2100 |
| NPI Number | 1528749827 |
|---|---|
| Provider Enumeration Date | 07/28/2023 |
| Last Update Date | 08/27/2024 |
| Medicare PECOS PAC ID | 3971957572 |
|---|---|
| Medicare Enrollment ID | O20231002000519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528749827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Marcus M Min |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912977430 PECOS PAC ID: 3173578432 Enrollment ID: I20050318000791 |
| Provider Name | Johna M Wix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043466139 PECOS PAC ID: 7416193743 Enrollment ID: I20130411000335 |
| Provider Name | Angie Riddle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962745356 PECOS PAC ID: 0143523126 Enrollment ID: I20160126000493 |
| Provider Name | Kerry Wilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396299731 PECOS PAC ID: 9830487586 Enrollment ID: I20231113002643 |
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