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General NPI Number Information
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NPI Number | 1538894514
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD HEALTH CENTER
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 2025 VIRGINIA AVE
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City | CONNERSVILLE
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State | IN
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Zip | 47331-2971
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Country | US
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Telephone | 765-827-8064
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Fax | 765-825-6999
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Provider Business Mailing Address
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Address Line | 101 S 10TH ST
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City | RICHMOND
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State | IN
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Zip | 47374-5547
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Country | US
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Telephone | 765-965-4299
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Fax | 765-962-0030
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISTY NASH
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Credential | CPCS
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Telephone | 765-983-3127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 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 #3
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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