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Organization

MADISONVILLE PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY JO HAYNIE MSN (OWNER)
(270) 339-3783
Entity
Organization

Contact information

Practice address
15 N HARRIG ST, MADISONVILLE, KY 42431-2123
(270) 339-3783
Mailing address
1035 BELL DR, MADISONVILLE, KY 42431-2333
(270) 339-3783

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
3005162
KY

Other

Enumeration date
07/09/2014
Last updated
07/09/2014
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