Boone County Community Health Clinic, Inc
Organization Active NPI Community Health Clinic/Center · Lebanon, IN
NPI 1962681734 · NPPES record last updated Feb 4, 2014
Key facts
- NPI
- 1962681734
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Health Clinic/Center 261QC1500X
- License
- 71000784B (IN)
- Legal business name
- BOONE COUNTY COMMUNITY HEALTH CLINIC, INC
- Practice address
- 416 W Camp St
Lebanon, IN 46052-1799 - Phone
- (765) 483-4469
- NPI assigned
- Oct 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Bambi McQuade-Jones, DNP, FNP-C
- Title
- Executive Director
- Phone
- (765) 483-4469
Practitioners 27
-
Allison Laine Bauer, NP-C
-
Christy Lanjie Chen, DDS
-
Patrick Doolan, MD
-
Christina Lynn Fleck, FNP-BC
-
Gregory Mark French, M.D.
-
Amy Kornhauser, FNP-BC
-
Valerie Lynne Legacy, FNP-BC
-
Tracy Dirk Sapp, D.D.S.
-
India Tapplar, FNP-C
-
Jinhai Zhang, DDS
-
Olushola Oluwole Ajadi, FNP-C
-
Wilberforce K Asare, AGPCNP-BC
-
Rita M Becker, NP
-
David Thomas Beine, AGPCNP-BC
-
Kiana Brothers, DNP, RN, CPNP-PC
-
Amy Renee Lipscomb, APRN
-
Qiaorong Liu, AGPCNP-BC
-
Timothy Poquette, PMHNP-BC
-
Cassandra Dawn Selby, RN, BSN, CNM, ARNP
-
Tasha Denise Snyder, LCSW
-
Madeleine L St. James, FNP-C
-
Jeffrey M Tessman, FNP-C
National Provider Directory
Locations
404 W Camp St
Lebanon, IN 46052
Phone (765) 483-4469
416 W Camp St
Lebanon, IN 46052
Phone (765) 483-4469
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | 71000784B | IN | Yes |
Addresses
Primary practice location
416 W Camp St
Lebanon, IN 46052-1799
Mailing address
416 W Camp St
Lebanon, IN 46052-1799
Phone (765) 483-4469
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100063430 | Medicaid | IN | |
| 200401120A | Medicaid | IN | |
| 200432840 | Medicaid | IN |
Other providers in Lebanon, IN
- Tara Boelke
- Hannah Boetscher
- Lacy Ann Boggs
- Boone County Auditor
- Boone County Chiropractic Office, PC
- Boone County Senior Services, Inc.
- Kevin Boone
- James Anthony Boudreau
- Andrew Joseph Bowman
- Madyson Boyer
All providers in Lebanon, IN · Community Health Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2014. 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.