Healthcare Provider Details

I. General information

NPI: 1083110373
Provider Name (Legal Business Name): FYI HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 HIGHWAY 41 NORTH
EVANSVILLE IN
47715
US

IV. Provider business mailing address

7145 E VIRGINIA ST
EVANSVILLE IN
47715-9144
US

V. Phone/Fax

Practice location:
  • Phone: 812-962-7890
  • Fax: 812-476-6162
Mailing address:
  • Phone: 812-962-7890
  • Fax: 812-476-6162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DONNIE WILCOX
Title or Position: BILLING MANAGER
Credential:
Phone: 812-962-7890