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Organization

ETOWN FAMILY PRACTICE PLC

Active
Other names
Etown Family Practice
Organization subpart
No

Provider details

NPI number
Authorized official
GWEN THOMAS APRN (APRN)
(270) 900-0192
Entity
Organization

Contact information

Practice address
1239 WOODLAND DR, SUITE 105, ELIZABETHTOWN, KY 42701-2770
(270) 900-0192
Mailing address
1239 WOODLAND DR, STE 105, ELIZABETHTOWN, KY 42701-2770
(270) 900-0192

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
KY3007643
KY
363LF0000X
Family Nurse Practitioner
Primary
3007643
KY

Other

Enumeration date
05/09/2013
Last updated
12/02/2014
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