Individual
DR. VANESSA JANE SHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
289 IRELAND AVE, IRELAND ARMY COMMUNITY HOSPITAL, FORT KNOX, KY 40121-5111
(502) 624-9864
Mailing address
175 MARY LEE ST, ELIZABETHTOWN, KY 42701-4481
(859) 839-9906
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01056852A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01056852A
GENERAL PRACTICE
IN
Enumeration date
11/23/2005
Last updated
11/13/2014
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