Organization
FAMILY CARE CLINIC PLLC
Active
Other names
Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JERYL L PITTMAN APRN (MEMBER/OWNER)
(859) 893-3588
Entity
Organization
Contact information
Practice address
3190 IRVINE RD, RICHMOND, KY 40475-9031
(859) 369-0070
Mailing address
3190 IRVINE RD, RICHMOND, KY 40475-9031
(859) 369-0070
(859) 369-0073
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
08/20/2018
Last updated
12/29/2020
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