Individual
NANCY SHUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13260 SERVICE RD, WALTON, KY 41094-9565
(859) 485-4116
(859) 485-1389
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 485-4116
(859) 485-1389
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30695
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080092539
RAILROAD MEDICARE
KY
05
—
2112994
—
OH
05
—
64306954
—
KY
01
—
P00840878
RAILROAD MEDICARE
KY
Enumeration date
06/27/2006
Last updated
12/14/2023
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