| Glen R Standafer, APRN | |
| 732 Highway 36, Frenchburg, KY 40322-8123 | |
| (606) 768-2191 | |
| (606) 768-6130 | 
| Full Name | Glen R Standafer | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Practitioner - Family | 
| Location | 732 Highway 36, Frenchburg, Kentucky | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1669759064 | NPI | - | NPPES | 
| 7100192030 | Medicaid | KY | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 3007175 (Kentucky) | Secondary | 
| 363LF0000X | Nurse Practitioner - Family | 3007175 (Kentucky) | Primary | 
| Entity Name | New Lexington Clinic Psc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1700803681 PECOS PAC ID: 3476457532 Enrollment ID: O20031121000103 | 
| Entity Name | Southern Medical Partners, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1538109962 PECOS PAC ID: 8123923679 Enrollment ID: O20031206000036 | 
| Entity Name | Southeastern Emergency Services P C | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1669414264 PECOS PAC ID: 6204730195 Enrollment ID: O20031219000755 | 
| Entity Name | Kentucky Em-i Medical Services Psc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1083869135 PECOS PAC ID: 8325001175 Enrollment ID: O20041111000775 | 
| Entity Name | Southeastern Emergency Physicians Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050302000285 | 
| Entity Name | Acs Primary Care Physicians-midwest | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1609811413 PECOS PAC ID: 3173435229 Enrollment ID: O20050816000693 | 
| Entity Name | Green Valley Emergency Physicians, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1720755739 PECOS PAC ID: 4385035534 Enrollment ID: O20230926000510 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Glen R Standafer, APRN 732 Highway 36, Frenchburg, KY 40322-8123 Ph: (606) 768-2191 | Glen R Standafer, APRN 732 Highway 36, Frenchburg, KY 40322-8123 Ph: (606) 768-2191 | 
| Morgan Morris, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 732 Highway 36, Frenchburg, KY 40322 Phone: 606-768-2191 Fax: 606-768-6130 | |
| Jennifer Richards Clark, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 784 Highway 36, Frenchburg, KY 40322 Phone: 606-768-9190 Fax: 606-768-9180 | |
| Marion J Leach, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 784 Highway 36, Frenchburg, KY 40322 Phone: 606-768-9190 Fax: 606-768-9180 | |
| Jamie Sheree Vance, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 784 Highway 36, Frenchburg, KY 40322 Phone: 606-768-9190 | |
| Mrs. Karen Metler, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 359 Wynn Flat Rd Rm 121, Frenchburg, KY 40322 Phone: 606-768-9190 Fax: 606-768-9180 | |
| Amy Back Brown, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 784 Highway 36, Frenchburg, KY 40322 Phone: 606-768-9190 Fax: 606-768-9180 | |
| Teresa Gevedon, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2085 Us Highway 460 E, Frenchburg, KY 40322 Phone: 606-768-3725 Fax: 606-464-0152 |