| Doctor Name: | MRS. SHANNON RENEE SHIRLEY |
| NPI Number: | 1235525809 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, RN, NP-C |
| License Number: | 3009340 |
| Business Practice Address: | 1501 S Dixie St Horse Cave, KY - 427491480 |
| Business Phone Number: | 2707862191 |
| Business Fax Number: | |
| Mailing Address: | 1495 S Dixie St, HORSE CAVE |
| State: | KY |
| Postal Code: | 427491457 |
| Phone Number: | 2707862372 |
| Fax Number: | 2707862472 |
| NPI Enumeration Date: | 04/10/2015 |
| NPI Last Update Date: | 05/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3009340 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |