| |
612 Barrett Blvd Henderson KY 42420-2620 | |
(270) 844-8232 | |
(270) 844-8238 |
Full Name | |
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Speciality | Nurse Practitioner |
Location | 612 Barrett Blvd, Henderson, Kentucky |
Authorized Official Name and Position | Jennifer Todd (OFFICE MANAGER/OWNER) |
Authorized Official Contact | 2708448232 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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612 Barrett Blvd Henderson KY 42420-2620 Ph: (270) 844-8232 | 612 Barrett Blvd Henderson KY 42420-2620 Ph: (270) 844-8232 |
NPI Number | 1972881324 |
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Provider Enumeration Date | 08/02/2011 |
Last Update Date | 05/09/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972881324 | NPI | - | NPPES |
7100179140 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
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