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Individual
HALEY RENEE SHANKS
Active
Individual
HALEY RENEE SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3327
KY
363A00000X
Physician Assistant
TC011
KY
363AM0700X
Medical Physician Assistant
PA3327
KY
363AM0700X
Medical Physician Assistant
TC011
KY
363AS0400X
Surgical Physician Assistant
PA3327
KY
363AS0400X
Surgical Physician Assistant
TC011
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
05/19/2023
Last updated
01/10/2024
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