# MRS. MARISSA EUSEBIO SHIH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629165956
- **Gender:** F
- **Credential:** A.P.R.N.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | 3180P | KY | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 3003180 | KY | Yes |

## Other

- **Enumeration date:** 10/06/2006
- **Last updated:** 09/19/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 61-0991301 | CORPORATION TAX ID | KY |
| 05 | — | 78004215 | — | KY |