Doctor Name: | MR. SHAUN MILBY |
NPI Number: | 1043686371 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | APRN |
License Number: | 3009666 |
Business Practice Address: | 2411 Ring Rd Suite 114 Elizabethtown, KY - 427015929 |
Business Phone Number: | 2707061925 |
Business Fax Number: | 2707061926 |
Mailing Address: | 2411 Ring Rd, Suite 114 ELIZABETHTOWN |
State: | KY |
Postal Code: | 427015929 |
Phone Number: | 2707061925 |
Fax Number: | 2707061926 |
NPI Enumeration Date: | 08/21/2015 |
NPI Last Update Date: | 08/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3009666 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |