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NPI Code Detail

MEDICARE: JENNIE STUART MEDICAL CENTER INC

MEDICARE: JENNIE STUART MEDICAL CENTER INC
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
12355A2700XAudiology Assistant
2363A00000XPhysician Assistant
3363AM0700XMedical Physician Assistant
4363AS0400XSurgical Physician Assistant
5363L00000XNurse Practitioner
6363LA2200XAdult Health Nurse Practitioner
7363LP2300XPrimary Care Nurse Practitioner
8363LW0102XWomen's Health Nurse Practitioner
91041C0700XClinical Social Worker
10133V00000XRegistered Dietitian
11231H00000XAudiologist
12363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1790086767
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNIE STUART MEDICAL CENTER INC
Provider Business Mailing Address
First Line : PO BOX 2400
Second Line :
City : HOPKINSVILLE
State : KY
Zip : 42241-2400
Country : US
Telephone Number : 270-887-0100
Fax Number : 270-887-0342
Provider Business Practice Location Address
First Line : 10755 EAGLE WAY STE 202
Second Line :
City : HOPKINSVILLE
State : KY
Zip : 42240-8742
Country : US
Telephone Number : 270-887-5640
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF PFS AND MANAGED CARE
Name : AUTUMN BAILEY
Credential :
Telephone Number : 270-887-0100
Provider Enumeration Date : 11/08/2010
Last Update Date : 04/09/2025

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Directions to “JENNIE STUART MEDICAL CENTER INC ” Practice Location

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