Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 3012554 | KY |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 3012554 | KY |
NPI | 1356824684 |
---|---|
Provider Name | Cheryl Shuffitt |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-3841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2018 |
Last Update Date | 27/07/2021 |