| Visavis Health Care Medical Group Of Ky Llc | |
|
1381 Campbell Ln Bowling Green KY 42104-1049 | |
| (929) 491-7333 | |
| Not Available |
| Full Name | Visavis Health Care Medical Group Of Ky Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1381 Campbell Ln, Bowling Green, Kentucky |
| Authorized Official Name and Position | Rekha Bhandari (OWNER) |
| Authorized Official Contact | 2127346621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Visavis Health Care Medical Group Of Ky Llc 831 Bedford Ave Ste 530 Brooklyn NY 11205-2801 Ph: () - | Visavis Health Care Medical Group Of Ky Llc 1381 Campbell Ln Bowling Green KY 42104-1049 Ph: (929) 491-7333 |
| NPI Number | 1427831197 |
|---|---|
| Provider Enumeration Date | 08/16/2023 |
| Last Update Date | 09/21/2023 |
| Medicare PECOS PAC ID | 8123473253 |
|---|---|
| Medicare Enrollment ID | O20231010002769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427831197 | NPI | - | NPPES |
| Provider Name | Jessica K Fichter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447643986 PECOS PAC ID: 5698087732 Enrollment ID: I20210519001913 |
| Provider Name | Tiffany Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659819944 PECOS PAC ID: 0941578058 Enrollment ID: I20230306002703 |
| Provider Name | Jessica Suzanne Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821675158 PECOS PAC ID: 5395145593 Enrollment ID: I20230523002104 |
| Provider Name | Jenna Michelle Koepke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851848352 PECOS PAC ID: 8426346826 Enrollment ID: I20231113000966 |
| Provider Name | Ana Hubert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528370897 PECOS PAC ID: 6406080613 Enrollment ID: I20231113002588 |
| Provider Name | Jasmine Marshall-anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205504180 PECOS PAC ID: 8426435454 Enrollment ID: I20240104004463 |
| Provider Name | Jerel Keith Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750843876 PECOS PAC ID: 4688008394 Enrollment ID: I20240207004118 |
| Provider Name | Heather Lisi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427685205 PECOS PAC ID: 7517398241 Enrollment ID: I20240529003421 |
| Provider Name | Marilyn Ek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487745493 PECOS PAC ID: 8022907906 Enrollment ID: I20240529003476 |
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