Healthcare Provider Details

I. General information

NPI: 1588403406
Provider Name (Legal Business Name): FNC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 E WALNUT ST
EVANSVILLE IN
47714-1205
US

IV. Provider business mailing address

2110 E WALNUT ST
EVANSVILLE IN
47714-1205
US

V. Phone/Fax

Practice location:
  • Phone: 812-453-6555
  • Fax: 812-916-4621
Mailing address:
  • Phone: 812-453-6555
  • Fax: 812-916-4621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code364SL0600X
TaxonomyLong-Term Care Clinical Nurse Specialist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GREGORY GEORGE WILLMING
Title or Position: OWNER
Credential:
Phone: 812-453-6555