Bluegrass Family Healthcare, PLLC

Organization Active NPI Primary Care Nurse Practitioner · Leitchfield, KY

NPI 1679914733 · NPPES record last updated May 21, 2021

Key facts

NPI
1679914733
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Nurse Practitioner 363LP2300X
License
3007397 (KY)
Legal business name
BLUEGRASS FAMILY HEALTHCARE, PLLC
Practice address
2337 Elizabethtown Rd
Leitchfield, KY 42754-9173
Phone
(270) 971-1388
NPI assigned
Jul 17, 2013
Organization subpart
No

Authorized official

Name
Richard D Basham, APRN
Title
Owner
Phone
(270) 971-1388

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Bluegrass Family Healthcare PLLC (2 organizations share this tax ID)

Locations

2337 Elizabethtown Rd
Leitchfield, KY 42754
Phone (270) 230-0272

100 E White Oak St
Leitchfield, KY 42754

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LP2300X 3007397 KY Yes

Addresses

Primary practice location

2337 Elizabethtown Rd
Leitchfield, KY 42754-9173

Mailing address

2337 Elizabethtown Rd
Leitchfield, KY 42754-9173
Phone (270) 971-1388

Other providers in Leitchfield, KY

All providers in Leitchfield, KY · Primary Care Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.