Shively, Susan Ashley

Shively, Susan Ashley is an sole proprietor health care provider with primary practice located at 803 Lebanon Ave , Campbellsville KY 42718-1809. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Shively, Susan Ashley can be contacted via phone (270) 465-2521.

Contact Information

Primary practice address
803 Lebanon Ave Campbellsville KY 42718-1809
Phone: (270) 465-2521
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3004973 Kentucky

Profile Details

NPI number 1972656379
LBN Legal business name Shively, Susan Ashley
Credentials CRNFA, MSN, FNP-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 19th, 2007
Last updated Apr 28th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972656379 NPPES
Kentucky MEDICAID 7100001600

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