| Fernan Family Practice | |
|
200 S. Mill St. Ridgway PA 15853 | |
| (814) 772-0722 | |
| (814) 772-6934 |
| Full Name | Fernan Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 200 S. Mill St., Ridgway, Pennsylvania |
| Authorized Official Name and Position | Kathlee M Fernan (OWNER) |
| Authorized Official Contact | 8147720722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fernan Family Practice 200 S. Mill St. Ridgway PA 15853 Ph: (814) 772-0722 | Fernan Family Practice 200 S. Mill St. Ridgway PA 15853 Ph: (814) 772-0722 |
| NPI Number | 1659608982 |
|---|---|
| Provider Enumeration Date | 11/06/2009 |
| Last Update Date | 01/13/2015 |
| Medicare PECOS PAC ID | 8022145671 |
|---|---|
| Medicare Enrollment ID | O20100429001143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659608982 | NPI | - | NPPES |
| 101638607 0006 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS013170 (Pennsylvania) | Primary |
| Provider Name | Kathleen Margaret Fernan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770584070 PECOS PAC ID: 5092754598 Enrollment ID: I20050425000956 |
| Provider Name | Megen R Handley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336120146 PECOS PAC ID: 3072744630 Enrollment ID: I20140324001395 |
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