Edmonton Primary Care Nursing Group
Organization Active NPI Family Nurse Practitioner · Edmonton, KY
NPI 1629240759 · NPPES record last updated Mar 28, 2008
Key facts
- NPI
- 1629240759
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1854P (KY)
- Legal business name
- EDMONTON PRIMARY CARE NURSING GROUP
- Practice address
- 903 West Stockton Street
Edmonton, KY 42129 - Phone
- (270) 432-5782
- Fax
- (270) 432-0001
- NPI assigned
- Mar 28, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- ADAIR COUNTY HOSPITAL DISTRICT
Authorized official
- Name
- Mr. Rex A Tungate
- Title
- Ceo, Administrator
- Phone
- (270) 384-4753
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Westlake Regional Hospital Medical Group
- Part of
- Westlake Regional Hospital Medical Group
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | 1854P | KY | Yes |
Addresses
Primary practice location
903 West Stockton Street
Edmonton, KY 42129
Mailing address
903 West Stockton Street
Edmonton, KY 42129
Phone (270) 432-5782
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7890217800 | Medicaid | KY |
Other providers in Edmonton, KY
- Cumberland Family Medical Center Inc
- Cumberland Family Medical Center Inc
- Cumberland Family Medical Center Inc
- Dr. Krista Harlan, D.C., P.S.C.
- Edmonton Family Vision Center PSC
- Kevin Emberton
- Tabatha M Engalnd
- Jill England
- Alysha Ervin
- Kela Everley
All providers in Edmonton, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.