| Son Shine Health And Wellness Center, Psc. | |
|
305 Morton Blvd Hazard KY 41701-9418 | |
| (606) 216-2599 | |
| Not Available |
| Full Name | Son Shine Health And Wellness Center, Psc. |
|---|---|
| Speciality | Family Medicine |
| Location | 305 Morton Blvd, Hazard, Kentucky |
| Authorized Official Name and Position | Veronica Lindsey Caudill-engle (OWNER/PROVIDER) |
| Authorized Official Contact | 6062162599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Son Shine Health And Wellness Center, Psc. 305 Morton Blvd Hazard KY 41701-9418 Ph: (606) 436-0514 | Son Shine Health And Wellness Center, Psc. 305 Morton Blvd Hazard KY 41701-9418 Ph: (606) 216-2599 |
| NPI Number | 1578210217 |
|---|---|
| Provider Enumeration Date | 03/02/2022 |
| Last Update Date | 09/11/2022 |
| Medicare PECOS PAC ID | 0042687667 |
|---|---|
| Medicare Enrollment ID | O20221110000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578210217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Deborah Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578566659 PECOS PAC ID: 0042487670 Enrollment ID: I20120121000074 |
| Provider Name | Veronica Caudill-engle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144513276 PECOS PAC ID: 4486898954 Enrollment ID: I20130924000131 |
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