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Organization
JENNINGS COUNTY WELLCARE PC
Active
Organization
JENNINGS COUNTY WELLCARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE PHILLIPS (CLINIC DIRECTOR)
(812) 346-4181
Entity
Organization
Contact information
Practice address
2200 N STATE HIGHWAY 7, NORTH VERNON, IN 47265-7192
(812) 346-4181
Mailing address
2200 N STATE HIGHWAY 7, NORTH VERNON, IN 47265-7192
(812) 346-4181
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/21/2024
Last updated
02/21/2024
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