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Individual

SHELBY JEAN THORNTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.P.R.N.

Contact information

Practice address
2300 CHAMBER CENTER DRIVE, SUITE 100, FORT MITCHELL, KY 41017-1673
(859) 341-3114
(859) 578-2156
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 341-3114
(859) 578-2156

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3005772
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3085138
OH
05
7100077370
KY
01
P00726170
RAILROAD MEDICARE
KY
01
P00821192
RAILROAD MEDICARE
KY
Enumeration date
07/29/2008
Last updated
09/11/2018
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