Organization
FMC LTC ACO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEFANIE FEEMSTER (CREDENTIALING DIRECTOR)
(806) 350-7325
Entity
Organization
Contact information
Practice address
2501 LAKEVIEW DR, AMARILLO, TX 79109-1531
(806) 355-8900
(806) 355-2453
Mailing address
2501 LAKEVIEW DR, AMARILLO, TX 79109-1531
(806) 355-8900
(806) 355-2453
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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