Provider Demographics
NPI:1013304344
Name:CORNERSTONE FAMILY HEALTH CARE, LLC
Entity Type:Organization
Organization Name:CORNERSTONE FAMILY HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:606-349-7710
Mailing Address - Street 1:RT 30 MIDDLEFORK BOX 535
Mailing Address - Street 2:
Mailing Address - City:SALYERSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41465-0535
Mailing Address - Country:US
Mailing Address - Phone:606-349-7710
Mailing Address - Fax:606-349-7720
Practice Address - Street 1:RT 30 MIDDLEFORK BOX 535
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-0535
Practice Address - Country:US
Practice Address - Phone:606-349-7710
Practice Address - Fax:606-349-7720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100397750Medicaid
KYK039712Medicare PIN