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Organization
CENTRAL KENTUCKY SURGICAL SERVICES LLC
Active
Organization
CENTRAL KENTUCKY SURGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN A. SHIVELY (OWNER)
27014652521
Entity
Organization
Contact information
Practice address
1700 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9615
(270) 465-2521
Mailing address
803 LEBANON AVE, CAMPBELLSVILLE, KY 42718-1809
(270) 465-2521
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/27/2007
Last updated
08/17/2007
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