Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 3016839 | KY |
NPI | 1003443540 |
---|---|
Provider Name | Ms. Erica Shireman |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-1675 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2020 |
Last Update Date | 02/11/2021 |