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Organization

BENTON HEALTH CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JASON FIESSINGER APRN (FAMILY NURSE PRACTITIONER)
(270) 527-3900
Entity
Organization

Contact information

Practice address
414 EAST 12TH STREET, BENTON, KY 42025
(270) 527-3900
(270) 527-3901
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-0834

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
KY 3122P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100016040
KY
Enumeration date
09/06/2006
Last updated
04/20/2012
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