SHONNA BACK Nurse Practitioner
Individual Provider (NPI-1)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1376734442- Provider Type
- Individual Provider (NPI-1)
- Credentials
- Nurse Practitioner
- Status
- Active
Contact & Location
- Address
- 130 PAVILION PKWY, NEWPORT, KY, 410712998
- Phone
- (859) 652-7203
- Fax
- (859) 652-7204
Specialties & Taxonomies
Nurse Practitioner, Family
Primary License: KY #3006274