Provider Demographics
NPI:1649861162
Name:EASTERN KENTUCKY HEALTH CARE PLLC
Entity type:Organization
Organization Name:EASTERN KENTUCKY HEALTH CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DNP
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:606-260-5570
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:STEARNS
Mailing Address - State:KY
Mailing Address - Zip Code:42647-0173
Mailing Address - Country:US
Mailing Address - Phone:606-825-0000
Mailing Address - Fax:606-825-0024
Practice Address - Street 1:161 COURT ST
Practice Address - Street 2:
Practice Address - City:WHITLEY CITY
Practice Address - State:KY
Practice Address - Zip Code:42653-5019
Practice Address - Country:US
Practice Address - Phone:606-825-0000
Practice Address - Fax:606-825-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty