ETOWN FAMILY PRACTICE PLC (NPI# 1922443480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922443480 |
| Entity Type | Organization |
| Organization Name | ETOWN FAMILY PRACTICE PLC |
| Other Organization Name | ETOWN FAMILY PRACTICE |
| Practice Address |
1239 Woodland Dr Suite 105 Elizabethtown KY 42701-2770 |
| Mailing Address |
1239 Woodland Dr Ste 105 Elizabethtown KY 42701-2770 |
| Practice Telephone | 2709000192 |
| Mailing Telephone | 2709000192 |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2014-12-02 |
| Authorized Official Name | GWEN THOMAS (APRN) |
| Authorized Official Telephone | 2709000192 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
KY3007643 | KY | Ambulatory Health Care Facilities |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3007643 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Etown Family Practice | Doing Business As Name - Organization |
| Street Address |
1239 WOODLAND DR SUITE 105 |
| City | ELIZABETHTOWN |
| State | KY |
| Zip Code | 42701-2770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609858539 | Ijaz Mahmood | Internal Medicine | 1239 Woodland Dr, Suite 105, Elizabethtown, KY 42701-2770 | 2005-11-16 |
| 1457992570 | Marinda Moore Schneider | Nurse Practitioner | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2019-09-30 |
| 1780246785 | Jordan Harrison | Behavior Technician | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2019-07-01 |
| 1700346665 | Tiffani Romayne Wallace | Behavior Technician | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2019-03-25 |
| 1881162428 | Kristina Marie Boshart | Behavioral Analyst | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2018-11-12 |
| 1598233132 | Sandrea L Patterson | Behavior Technician | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2018-11-12 |
| 1164970448 | Heartland Whole Brain Learning-pediatric & Adult Therapy LLC | Developmental Therapist | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2016-09-15 |
| 1114263100 | Wisdom Key Behavioral Health Services Inc | Nurse Practitioner | 1239 Woodland Dr, Suite 110, Elizabethtown, KY 42701-2770 | 2012-12-18 |
| 1609154442 | Ernest Lee Towns | Counselor | 1239 Woodland Dr, Suite 116, Elizabethtown, KY 42701-2770 | 2011-07-27 |
| 1780971846 | Sheryl L Hanawalt | Podiatrist | 1239 Woodland Dr, Suite 101, Elizabethtown, KY 42701-2770 | 2011-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
| 1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
| 1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
| 1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
| 1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
| 1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
| Find all providers in zip 42701 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619584653 | Craig H Dutton | Nurse Practitioner | 609 Il Route 146 E, Elizabethtown, IL 62931-4015 | 2020-09-24 |
| 1568077246 | Brittany Danyale Brashear | Nurse Practitioner | 2407 Ring Rd Ste 114, Elizabethtown, KY 42701-5938 | 2020-09-10 |
| 1528613171 | Aaron Benjamin Newton | Nurse Practitioner | 394 Brentwood Dr, Elizabethtown, KY 42701-5376 | 2019-08-09 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1063970366 | Melissa Anne Baumgardner | Nurse Practitioner | 1311 Ring Rd Ste 105, Elizabethtown, KY 42701-8963 | 2019-03-05 |
| 1255809596 | Cumberland Family Medical Center, Inc. | Nurse Practitioner | 1323 St John Rd, Elizabethtown, KY 42701-8745 | 2018-11-05 |
| 1700396959 | Tanya F Revor | Nurse Practitioner | 1321 Ring Rd Ste 107, Elizabethtown, KY 42701-8940 | 2017-10-02 |
| 1235586116 | Richard Clint Cron | Nurse Practitioner | 2413 Ring Road Suite 122, Elizabethtown, KY 42701 | 2016-05-19 |
| 1518358431 | Jessica Muth | Nurse Practitioner | 1239 Woodland Dr Ste 108, Elizabethtown, KY 42701 | 2015-02-13 |
| 1689083750 | Bisona Yeba Bennett | Nurse Practitioner | 120 Helmwood Plaza Dr Ste 200, Elizabethtown, KY 42701 | 2014-08-04 |
| Find all providers in ELIZABETHTOWN | ||||
| City | ELIZABETHTOWN |
| Zip Code | 42701 |
Please comment or provide details below to improve the information on ETOWN FAMILY PRACTICE PLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.