Kenna  H  Nettles    PA-C
Contract Details
Eastern Shore Urgent Care
Facility name
Provider ID
P000008554
NPI
1992076467
Tax ID
260765701
Effective Date
1/18/2017
Last Updated
1/18/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
29710 Urgent Care Drive
Daphne, AL 36526
United States
County
Baldwin
Phone
2516263782 (Phone)
Billing Details
Address
P.O. Box 4152
Belfast, ME 04915
Billing Phone
8007000278
Specialty Type
Urgent Care
Map
Address