Pinelake Physician Practice LLC

NPI #1437614633 in Clinton, Kentucky

Provider Information

NPI Number
1437614633
Entity Type
Organization
Organization Name
Pinelake Physician Practice LLC
Primary Specialty
Clinic/Center - Rural Health
Enumeration Date
Feb 1, 2019
Last Updated
Jun 11, 2019

Practice Location

Address
106 W CLAY ST
ZIP Code
42031-1317
Phone
(270) 653-0220

Authorized Official

Name
SHARLEE LEBLEU
Title
SR DIRECTOR, PROVIDER ENROLLMENT
Phone
(615) 920-7192

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner
Nurse Practitioner - FamilyFamily
Family Medicine
Obstetrics & Gynecology - ObstetricsObstetrics
Clinic/Center - Rural HealthRural Health

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