Provider Demographics
NPI:1407187941
Name:HOPE FAMILY CLINIC, PLLC
Entity Type:Organization
Organization Name:HOPE FAMILY CLINIC, PLLC
Other - Org Name:BRENDA J. PITTMAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:859-432-8168
Mailing Address - Street 1:506 N MAYSVILLE ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-9679
Mailing Address - Country:US
Mailing Address - Phone:859-432-8168
Mailing Address - Fax:859-432-8163
Practice Address - Street 1:506 MAYSVILLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9317
Practice Address - Country:US
Practice Address - Phone:859-432-8168
Practice Address - Fax:859-432-8163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78012085Medicaid
1609884287OtherNPI
KY78012085Medicaid
0735905Medicare PIN