| Stephanie N. Southard, Psc | |
|
1215 N Main St Suite 2 Monticello KY 42633-2900 | |
| (606) 340-8825 | |
| (606) 340-0097 |
| Full Name | Stephanie N. Southard, Psc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1215 N Main St, Monticello, Kentucky |
| Authorized Official Name and Position | Stephanie Nicole Southard (PRESIDENT) |
| Authorized Official Contact | 6063408825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie N. Southard, Psc 1215 N Main St Suite 2 Monticello KY 42633-2900 Ph: (606) 340-8825 | Stephanie N. Southard, Psc 1215 N Main St Suite 2 Monticello KY 42633-2900 Ph: (606) 340-8825 |
| NPI Number | 1629267315 |
|---|---|
| Provider Enumeration Date | 10/18/2007 |
| Last Update Date | 06/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629267315 | NPI | - | NPPES |
| 64061807 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 02809 (Kentucky) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
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