Healthcare Provider Details

I. General information

NPI: 1134606403
Provider Name (Legal Business Name): HOPE PRIMARY & URGENT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2157 S HIGHWAY 27
STEARNS KY
42647-6297
US

IV. Provider business mailing address

PO BOX 28
STEARNS KY
42647-0028
US

V. Phone/Fax

Practice location:
  • Phone: 606-376-9700
  • Fax: 606-376-9703
Mailing address:
  • Phone: 606-376-9700
  • Fax: 606-376-9703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLARISSA TUCKER
Title or Position: OFFICE MANAGER
Credential:
Phone: 606-376-9700