| Chelsey Pettis, | |
|
100 Edwina St, Evergreen, AL 36401-3319 | |
| (251) 578-0278 | |
| (251) 578-1055 |
| Full Name | Chelsey Pettis |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 100 Edwina St, Evergreen, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346799871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 1-098965 (Alabama) | Primary |
| Entity Name | Rural Urgent Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932586476 PECOS PAC ID: 8820305600 Enrollment ID: O20150910001722 |
| Entity Name | Nes Tennessee, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437606605 PECOS PAC ID: 3678472040 Enrollment ID: O20161031002328 |
| Mailing Address | Practice Location Address |
|---|---|
| Chelsey Pettis, 101 Crestview Ave, Evergreen, AL 36401-3333 Ph: (251) 578-2480 | Chelsey Pettis, 100 Edwina St, Evergreen, AL 36401-3319 Ph: (251) 578-0278 |
Jessica Roberts Pierce, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 106 Edwina Street, Evergreen, AL 36401 Phone: 251-578-4300 Fax: 251-578-4307 | |
Mrs. Lisa Marie Ripple, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 101 Crestview Ave, Evergreen, AL 36401 Phone: 251-578-0176 | |
Mrs. Haley Nobles Falkenberry, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Evergreen Family Health Center, 316 S. Main St, Evergreen, AL 36401 Phone: 251-578-2507 Fax: 251-578-3668 | |
Rickey Allen Blackburn Jr., CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 102 Edwina St, Evergreen, AL 36401 Phone: 251-578-0220 Fax: 251-578-0223 |