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The Functional Family Primary Care, LLC

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Company Details

Name: The Functional Family Primary Care, LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 12 Feb 2023 (2 years ago)
Organization Date: 12 Feb 2023 (2 years ago)
Last Annual Report: 14 Sep 2024 (10 months ago)
Managed By: Members
Organization Number: 1259791
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42301
City: Owensboro, Saint Joseph, St Joseph, Stanley
Primary County: Daviess County
Principal Office: 920 Frederica St Ste 104, Owensboro, KY 42301
Place of Formation: KENTUCKY

Member

Name Role
Jamie Durham Member
Brittany Mattingly Member

Organizer

Name Role
Jamie Durham Organizer

Registered Agent

Name Role
Jamie Durham Registered Agent

National Provider Identifier

NPI Number:
1164121588
Certification Date:
2023-04-24

Authorized Person:

Name:
JAMIE DURHAM
Role:
NURSE PRACTITIONER/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
8662487894

Filings

Name File Date
Annual Report 2024-09-14
Principal Office Address Change 2023-02-23

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Sources: Kentucky Secretary of State