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General NPI Number Information
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NPI Number | 1235897596
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Entity Type | Organization
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Legal Business Name | THREE RIVERS MEDICAL CLINICS INC
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Dates
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Enumeration Date | 12/03/2021
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 2673 HIGHWAY 644 STE 2
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City | LOUISA
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State | KY
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Zip | 41230-5922
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Country | US
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Telephone | 606-638-9572
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5009
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City | BRENTWOOD
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State | TN
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Zip | 37024-5009
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Country | US
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Telephone | 615-221-1400
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Fax |
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Authorized Official
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Title or Position | SR. DIRECTOR REVENUE CYCLE
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Name | LAURA J FEY
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Credential |
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Telephone | 615-221-3641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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