# GATEWAY PRIMARY CARE, LLC

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

## Provider details

- **NPI number:** 1215306816
- **Authorized official:** JOHN MCNULTY (OWNER)
- **Authorized official phone:** (270) 663-9410

## Contact information

- **Practice address:** 3245 MOUNT MORIAH AVE, SUITE 9, OWENSBORO, KY 42303-7834
- **Practice address phone:** (270) 683-2209
- **Practice address fax:** (270) 926-8261
- **Mailing address:** 3245 MOUNT MORIAH AVE, SUITE 9, OWENSBORO, KY 42303-7834
- **Mailing address phone:** (270) 683-2209
- **Mailing address fax:** (270) 926-8261

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/24/2015
- **Last updated:** 09/01/2017