Healthcare Provider Details
I. General information
NPI: 1629001276
Provider Name (Legal Business Name): WOMEN'S WELLNESS FIRST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2211 MAYFAIR DR SUITE 305
OWENSBORO KY
42301-4568
US
IV. Provider business mailing address
2211 MAYFAIR DR SUITE 305
OWENSBORO KY
42301-4568
US
V. Phone/Fax
- Phone: 270-685-8235
- Fax: 270-685-8238
- Phone: 270-685-8235
- Fax: 270-685-8238
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINE
BRIONES
Title or Position: OWNER/MANAGING MEMBER
Credential: M.D.
Phone: 270-685-8235