MEDICARE: MOBILE HEALTHCARE

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
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1730758731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE HEALTHCARE

Provider Business Mailing Address
First Line	:	11510 WILLOW BRANCH DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40291-4525
Country	:	US
Telephone Number	:	502-807-0726
Fax Number	:	502-713-2523

Provider Business Practice Location Address
First Line	:	11510 WILLOW BRANCH DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40291-4525
Country	:	US
Telephone Number	:	502-807-0726
Fax Number	:	502-713-2523

Authorized Official
Title or Position	:	OWNER
Name	:	TEETEH NARTEH
Credential	:	APRN
Telephone Number	:	502-807-0726

Provider Enumeration Date	:	06/23/2021
Last Update Date	:	06/23/2021

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Directions to “MOBILE HEALTHCARE ” Practice Location

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