Individual
SHANNON LEIGH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
12010 SHELBYVILLE RD, STE 500, LOUISVILLE, KY 40243-1054
(502) 238-2800
(502) 238-2805
Mailing address
PO BOX 950166, LOUISVILLE, KY 40295-0166
(502) 253-1035
(502) 253-1037
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4407P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78015963
—
KY
Enumeration date
03/21/2006
Last updated
08/04/2010
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