| Jackson Health And Wellness Clinic, Llc | |
|
102 Physicians Blvd Ste B Glasgow KY 42141-1299 | |
| (270) 629-6722 | |
| (270) 629-6723 |
| Full Name | Jackson Health And Wellness Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 102 Physicians Blvd Ste B, Glasgow, Kentucky |
| Authorized Official Name and Position | Britney Jackson (CEO) |
| Authorized Official Contact | 2706296722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Health And Wellness Clinic, Llc 102 Physicians Blvd Ste B Glasgow KY 42141-1299 Ph: (270) 629-6722 | Jackson Health And Wellness Clinic, Llc 102 Physicians Blvd Ste B Glasgow KY 42141-1299 Ph: (270) 629-6722 |
| NPI Number | 1730534090 |
|---|---|
| Provider Enumeration Date | 04/24/2016 |
| Last Update Date | 06/27/2023 |
| Medicare PECOS PAC ID | 0749575611 |
|---|---|
| Medicare Enrollment ID | O20160817002068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730534090 | NPI | - | NPPES |
| 7100144360 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Britney M Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043521289 PECOS PAC ID: 2466632468 Enrollment ID: I20110208000934 |
| Provider Name | Brandy Gayle Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215217328 PECOS PAC ID: 8820260078 Enrollment ID: I20111011000765 |
| Provider Name | Ashley Rae Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619662038 PECOS PAC ID: 3870953649 Enrollment ID: I20230712003240 |
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