Constance R Prostko (NPI# 1508836487, PAC ID# 5799730388) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1508836487 |
| PAC ID by PECOS | 5799730388 |
| Professional Enrollment ID | I20050316000770 |
| Full Name | Constance R Prostko |
| Organization Legal Name | T J HEALTH COLUMBIA INC |
| Address |
1704 W Stockton St Edmonton KY 42129-8137 |
| Phone Number | 2704324800 |
| Gender | F |
| Credential | NP |
| Graduation Year | 1998 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7113224783 |
| Number of Group Practice Members | 22 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180017 | T J SAMSON COMMUNITY HOSPITAL |
| 180149 | TJ HEALTH COLUMBIA |
| Address | Phone | Organization |
|---|---|---|
| 1704 W Stockton St, Edmonton, KY 42129-8137 | 2704324800 | T J HEALTH COLUMBIA INC |
| Organization Legal Name | T J HEALTH COLUMBIA INC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia L Doolin | Nurse Practitioner | T J Health Columbia Inc | 902 Westlake Dr, Suite 101, Columbia, KY 42728-1149 |
| Nicole L Loy | Nurse Practitioner | T J Health Columbia Inc | 2465 Lakeway Dr, Russell Springs, KY 42642-4510 |
| Ashley L Robertson | Nurse Practitioner | T J Health Columbia Inc | 810 Jamestown St, Columbia, KY 42728-1010 |
| Teresa L Sheffield | Nurse Practitioner | T J Health Columbia Inc | 800 N Main St, Suite B, Tompkinsville, KY 42167-1037 |
| Clinton Kiteck | Family Medicine | T J Health Columbia Inc | 810 Jamestown St, Columbia, KY 42728-1010 |
| Eric W Townsend | Nurse Practitioner | T J Health Columbia Inc | 810 Jamestown St, Columbia, KY 42728-1010 |
| Latasha E Gilpatrick | Nurse Practitioner | T J Health Columbia Inc | 2465 Lakeway Dr, Russell Springs, KY 42642-4510 |
| Paul D Dunn | Family Medicine | T J Health Columbia Inc | 1704 W Stockton St, Edmonton, KY 42129-8137 |
| Khabeer M Abdul | Nurse Practitioner | T J Health Columbia Inc | 1704 W Stockton St, Edmonton, KY 42129-8137 |
| Street Address |
1704 W STOCKTON ST |
| City | EDMONTON |
| State | KY |
| Zip | 42129-8137 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul D Dunn | Family Medicine | T J Health Columbia Inc | 1704 W Stockton St, Edmonton, KY 42129-8137 |
| Khabeer M Abdul | Nurse Practitioner | T J Health Columbia Inc | 1704 W Stockton St, Edmonton, KY 42129-8137 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert N Whitlow Ii | Optometry | Edmonton Family Vision Center Psc | 1406 W Stockton St, Edmonton, KY 42129-8125 |
| Cheryl G Whitlow | Optometry | Edmonton Family Vision Center Psc | 1406 W Stockton St, Edmonton, KY 42129-8125 |
| Shelbie Rae Wells | Clinical Social Worker | Lifeskills, Inc | 112 Sartin Dr, Edmonton, KY 42129-8170 |
| Angela Marie Jessie | Nurse Practitioner | 109 Sartin Dr, Edmonton, KY 42129-8170 | |
| Kelly Mcmurtrey Thompson | Chiropractic | 106 W Stockton St, Edmonton, KY 42129-9403 |
| City | EDMONTON |
| Zip Code | 42129 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | EDMONTON + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Constance R Prostko.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.