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NPI Code Detail

MEDICARE: FH&L FAMILY PRACTICE LLC

MEDICARE: FH&L FAMILY PRACTICE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner
2363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1063809523
Entity Type Code : Organization
Provider Name (Legal Business Name) : FH&L FAMILY PRACTICE LLC
Provider Business Mailing Address
First Line : PO BOX 26
Second Line :
City : EDMONTON
State : KY
Zip : 42129-0026
Country : US
Telephone Number : 270-432-2444
Fax Number : 270-432-2445
Provider Business Practice Location Address
First Line : 109 SARTIN DR
Second Line :
City : EDMONTON
State : KY
Zip : 42129-8170
Country : US
Telephone Number : 270-670-5960
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ANGELA JESSIE
Credential : APRN
Telephone Number : 270-432-2444
Provider Enumeration Date : 04/22/2015
Last Update Date : 03/17/2018

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Directions to “FH&L FAMILY PRACTICE LLC ” Practice Location

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