Organization
ONE CROSS HEALTH CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY ROSE MCKENNA APRN (PRESIDENT)
(270) 403-1106
Entity
Organization
Contact information
Practice address
106 WINSTON WAY, CAMPBELLSVILLE, KY 42718-4953
(270) 789-0034
(270) 789-0097
Mailing address
106 WINSTON WAY, CAMPBELLSVILLE, KY 42718-4953
(270) 789-0034
(270) 789-0097
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
3004091
KY
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100657890
—
KY
01
—
K124131
MEDICARE
KY
Enumeration date
11/10/2014
Last updated
12/01/2022
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