Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3008555 | KY |
NPI | 1386063071 |
---|---|
Provider Name | Shannon Curry |
First Address | Viper, KY 41774-0145 |
Second Address | Viper, KY 41774 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2014 |
Last Update Date | 10/04/2014 |