| Doctor Name: | DR. VANESSA JANE SHANK |
| NPI Number: | 1053394940 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 01056852A |
| Business Practice Address: | 289 Ireland Ave Ireland Army Community Hospital Fort Knox, KY - 401215111 |
| Business Phone Number: | 5026249864 |
| Business Fax Number: | |
| Mailing Address: | 175 Mary Lee St, ELIZABETHTOWN |
| State: | KY |
| Postal Code: | 427014481 |
| Phone Number: | 8598399906 |
| Fax Number: | |
| NPI Enumeration Date: | 11/23/2005 |
| NPI Last Update Date: | 11/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01056852A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |