Organization
KENTUCKY STUDENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW STIVERS (PRESIDENT)
(502) 352-8896
Entity
Organization
Contact information
Practice address
211 BREIGHTON CIR STE 11A, SHELBYVILLE, KY 40065-8150
(502) 352-8896
(502) 633-0387
Mailing address
211 BREIGHTON CIR STE 11A, SHELBYVILLE, KY 40065-8150
(502) 352-8896
(502) 633-0387
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/28/2022
Last updated
12/12/2022
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