| Kentwood Family Clinic Llc | |
|
919 Avenue G Kentwood LA 70444 | |
| (337) 991-9276 | |
| (337) 991-9288 |
| Full Name | Kentwood Family Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 919 Avenue G, Kentwood, Louisiana |
| Authorized Official Name and Position | Nicole Howard (CEO) |
| Authorized Official Contact | 3379919276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentwood Family Clinic Llc 1509 Dulles Dr Lafayette LA 70506-3718 Ph: (337) 991-9276 | Kentwood Family Clinic Llc 919 Avenue G Kentwood LA 70444 Ph: (337) 991-9276 |
| NPI Number | 1780050294 |
|---|---|
| Provider Enumeration Date | 08/19/2015 |
| Last Update Date | 03/02/2020 |
| Medicare PECOS PAC ID | 4082923099 |
|---|---|
| Medicare Enrollment ID | O20151014000474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780050294 | NPI | - | NPPES |
| Provider Name | Bryan D Tate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407177348 PECOS PAC ID: 9638202476 Enrollment ID: I20100730000884 |
| Provider Name | Tara L Kempton-jerez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376977413 PECOS PAC ID: 7618107905 Enrollment ID: I20140306001365 |
| Provider Name | Amber T Creel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760859896 PECOS PAC ID: 1355651977 Enrollment ID: I20151112000258 |
| Provider Name | Mary Katherine Verberne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255871596 PECOS PAC ID: 6406123520 Enrollment ID: I20170522000635 |
| Provider Name | Brandy Nicole Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184200347 PECOS PAC ID: 9638570906 Enrollment ID: I20210623003562 |
Southeast Community Health Systems Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 9th St, Kentwood, LA 70444 Phone: 985-514-2085 | |
Southeast Community Health Systems Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1459 Service Rd, Kentwood, LA 70444 Phone: 888-414-7247 Fax: 225-658-1282 | |
Southeast Community Health Systems Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 68495 Highway 1054, Kentwood, LA 70444 Phone: 225-306-2000 Fax: 225-658-1282 | |
Southeast Community Health Systems Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15649 Highway 440, Kentwood, LA 70444 Phone: 225-306-2000 Fax: 225-658-1282 | |
Southeast Community Health Systems @ Kentwood Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 721 Avenue G, Kentwood, LA 70444 Phone: 985-229-5507 Fax: 985-229-6828 | |
Southeast Community Health Systems Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15841 Highway 440, Kentwood, LA 70444 Phone: 225-306-2000 Fax: 225-658-1282 | |
Schilling Health Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 210 Avenue G, Kentwood, LA 70444 Phone: 985-269-1817 |