Organization
SOUTHEAST FAMILY PRACTICE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAMPAS S NOLAN APRN (APRN / OWNER)
(606) 654-6210
Entity
Organization
Contact information
Practice address
222 W TENNESSEE AVE, PINEVILLE, KY 40977-1737
(606) 499-5135
Mailing address
222 W TENNESSEE AVE, PINEVILLE, KY 40977-1737
(606) 499-5135
(606) 654-6220
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/22/2018
Last updated
12/08/2023
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