Organization
COUNTRYSIDE FAMILY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE M BERRY CPC (OFFCIE MANAGER)
(270) 233-2024
Entity
Organization
Contact information
Practice address
1041 US HIGHWAY 231 N, HARTFORD, KY 42347-9402
(270) 233-2024
(270) 233-0202
Mailing address
PO BOX 585, HARTFORD, KY 42347-0585
(270) 233-2024
(270) 233-0202
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008378
KY
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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