| Wind Horse Crossing Pllc | |
|
423 E Mckinney Ave Rogersville TN 37857-3339 | |
| (760) 275-8598 | |
| (423) 500-0119 |
| Full Name | Wind Horse Crossing Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 423 E Mckinney Ave, Rogersville, Tennessee |
| Authorized Official Name and Position | Nancy Kaye Waite-o'brien (PRESIDENT) |
| Authorized Official Contact | 7602758598 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wind Horse Crossing Pllc 423 E Mckinney Ave Rogersville TN 37857-3339 Ph: (760) 275-8598 | Wind Horse Crossing Pllc 423 E Mckinney Ave Rogersville TN 37857-3339 Ph: (760) 275-8598 |
| NPI Number | 1982435301 |
|---|---|
| Provider Enumeration Date | 08/08/2024 |
| Last Update Date | 08/08/2024 |
| Certification Date | 08/08/2024 |
| Medicare PECOS PAC ID | 0345777421 |
|---|---|
| Medicare Enrollment ID | O20241231003494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982435301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Nancy K Waite-o'brien |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1528450384 PECOS PAC ID: 2163842758 Enrollment ID: I20250102000416 |
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