Individual
SHAMPANE D GULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 E LEXINGTON AVE, WINCHESTER, KY 40391-2052
(859) 432-3055
Mailing address
121 E LEXINGTON AVE, WINCHESTER, KY 40391-2052
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
06/28/2022
Last updated
02/02/2026
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