# JENNINGS COUNTY WELLCARE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194580886
- **Authorized official:** BRUCE PHILLIPS (CLINIC DIRECTOR)
- **Authorized official phone:** (812) 346-4181

## Contact information

- **Practice address:** 2200 N STATE HIGHWAY 7, NORTH VERNON, IN 47265-7192
- **Practice address phone:** (812) 346-4181
- **Mailing address:** 2200 N STATE HIGHWAY 7, NORTH VERNON, IN 47265-7192
- **Mailing address phone:** (812) 346-4181

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2024
- **Last updated:** 02/21/2024