| Specialistsmat Psc | |
|
110 Chase Way Ste 2 Elizabethtown KY 42701-7827 | |
| (502) 212-0071 | |
| (502) 530-5303 |
| Full Name | Specialistsmat Psc |
|---|---|
| Speciality | Anesthesiology |
| Location | 110 Chase Way Ste 2, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Cara Nicole Netherton (PRACTICE MANAGER) |
| Authorized Official Contact | 8592486415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialistsmat Psc 110 Chase Way Ste 2 Elizabethtown KY 42701-7827 Ph: (502) 212-0071 | Specialistsmat Psc 110 Chase Way Ste 2 Elizabethtown KY 42701-7827 Ph: (502) 212-0071 |
| NPI Number | 1851998181 |
|---|---|
| Provider Enumeration Date | 10/09/2020 |
| Last Update Date | 08/07/2024 |
| Certification Date | 08/07/2024 |
| Medicare PECOS PAC ID | 7810307634 |
|---|---|
| Medicare Enrollment ID | O20201106001396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851998181 | NPI | - | NPPES |
| Provider Name | Guy Mark Lerner |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1770671547 PECOS PAC ID: 5395977029 Enrollment ID: I20140411001665 |
| Provider Name | Donald R Zinno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750831137 PECOS PAC ID: 2567745755 Enrollment ID: I20170214001138 |
| Provider Name | Craig Douglas Rouben |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043562267 PECOS PAC ID: 5799902318 Enrollment ID: I20180413001403 |
| Provider Name | Monica Trista Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730894817 PECOS PAC ID: 5092188219 Enrollment ID: I20230308001599 |
| Provider Name | Brandi Elizabeth Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013227446 PECOS PAC ID: 6406384445 Enrollment ID: I20250103003198 |
| Provider Name | Brooke Bischoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831978998 PECOS PAC ID: 9133657851 Enrollment ID: I20250109000081 |
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