| Southeast Family Practice PSC | |
|
222 W Tennessee Ave Pineville KY 40977-1737 | |
| (606) 499-5135 | |
| Not Available |
| Full Name | Southeast Family Practice PSC |
|---|---|
| Speciality | Clinic/Center |
| Location | 222 W Tennessee Ave, Pineville, Kentucky |
| Authorized Official Name and Position | Trampas S Nolan (APRN / OWNER) |
| Authorized Official Contact | 6066546210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Family Practice PSC 222 W Tennessee Ave Pineville KY 40977-1737 Ph: (606) 499-5135 | Southeast Family Practice PSC 222 W Tennessee Ave Pineville KY 40977-1737 Ph: (606) 499-5135 |
| NPI Number | 1033600416 |
|---|---|
| Provider Enumeration Date | 05/22/2018 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Medicare PECOS PAC ID | 0941550149 |
|---|---|
| Medicare Enrollment ID | O20180910002071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033600416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| 363LF0000X | Nurse Practitioner - Family | () | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | () | Secondary |
| Provider Name | Trampas S Nolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033144191 PECOS PAC ID: 8921072091 Enrollment ID: I20040824000741 |
| Provider Name | Aaron N Frye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083030860 PECOS PAC ID: 7911120803 Enrollment ID: I20140527000917 |
| Provider Name | Jennie Katelyn Nolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659054534 PECOS PAC ID: 0446601710 Enrollment ID: I20240213004238 |
Pineville Community Hospital Association, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 850 Riverview Ave, Pineville, KY 40977 Phone: 606-337-3051 |
Total Care Rural Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 850 Riverview Ave, Pineville, KY 40977 Phone: 606-654-4775 Fax: 606-654-2613 |
Adventhealth Pineville Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12904 Robert L Madon Byp Ste 2, Pineville, KY 40977 Phone: 606-598-4508 Fax: 606-712-1200 |
Southeastern Ky Total Care Rhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 W Virginia Ave, Pineville, KY 40977 Phone: 606-337-3051 Fax: 606-337-2871 |
Pine Mountain Clinic PSC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 850 Riverview Rd, Pineville, KY 40977 Phone: 606-337-6047 Fax: 606-337-0925 |
Jerry L. Woolum, M.D., P.S.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 Virginia Avenue, Suite F200, Pineville, KY 40977 Phone: 606-337-0860 Fax: 606-337-9956 |