Individual
JACLYN SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 494-9521
Mailing address
205 SUNSET DR, LAWRENCEBURG, KY 40342-1458
(502) 494-9521
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
1138276
KY
363LF0000X
Family Nurse Practitioner
Primary
4008949
KY
Other
Enumeration date
07/11/2023
Last updated
06/25/2024
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