Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 3005617 | KY |
N | 363LA2100X | Nurse Practitioner - Acute Care | 3005617 | KY |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 3005617 | KY |
NPI | 1013184266 |
---|---|
Provider Name | Shanna M Meyers |
First Address | Lexington, KY 40536-0293 |
Second Address | Lexington, KY 40536-1200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 03/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3005617 | LICENSE (01) | KY |
7100061270 | (05) | KY |