Organization
METHODIST HEALTH, INC.
Active
Other names
Deaconess Henderson Pediatrics Elm St
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE JENKINS (VP)
(270) 827-7118
Entity
Organization
Contact information
Practice address
2000 N ELM ST, HENDERSON, KY 42420-2385
(270) 827-3573
(270) 827-1250
Mailing address
PO BOX 638706, CINCINNATI, OH 45263-8706
(270) 827-3573
(270) 827-1250
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100279200
—
KY
Enumeration date
08/16/2013
Last updated
11/17/2020
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