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602 Cannons Point Ln # Mc Mc Daniels KY 40152-7017 | |
(270) 668-4246 | |
Not Available |
Full Name | |
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Speciality | Nurse Practitioner |
Location | 602 Cannons Point Ln # Mc, Mc Daniels, Kentucky |
Authorized Official Name and Position | Alelea Hewitt (APRN) |
Authorized Official Contact | 2706684246 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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602 Cannons Point Ln Mc Daniels KY 40152-7017 Ph: (270) 668-4246 | 602 Cannons Point Ln # Mc Mc Daniels KY 40152-7017 Ph: (270) 668-4246 |
NPI Number | 1457034720 |
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Provider Enumeration Date | 08/11/2023 |
Last Update Date | 11/07/2023 |
Medicare PECOS PAC ID | 4880058825 |
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Medicare Enrollment ID | O20230911001009 |
Identifier | Type | State | Issuer |
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1457034720 | NPI | - | NPPES |
Provider Name | Alelea Blanco Hewitt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972973865 PECOS PAC ID: 4789984055 Enrollment ID: I20151118002995 |