Provider Demographics
NPI:1134825664
Name:ASSURED HEALTHCARE CLINIC
Entity type:Organization
Organization Name:ASSURED HEALTHCARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NP
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:849-358-2051
Mailing Address - Street 1:1870 BOONESBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-9323
Mailing Address - Country:US
Mailing Address - Phone:859-358-2051
Mailing Address - Fax:
Practice Address - Street 1:217 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-2332
Practice Address - Country:US
Practice Address - Phone:859-358-2051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty