Healthcare Provider Details

I. General information

NPI: 1457784126
Provider Name (Legal Business Name): METHODIST HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N ELM ST
HENDERSON KY
42420-2385
US

IV. Provider business mailing address

PO BOX 638706
CINCINNATI OH
45263-8706
US

V. Phone/Fax

Practice location:
  • Phone: 270-827-3573
  • Fax: 270-827-1250
Mailing address:
  • Phone: 270-827-3573
  • Fax: 270-827-1250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE JENKINS
Title or Position: VP
Credential:
Phone: 270-827-7118