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HEATHER NICOLE MASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
438 ADAM SHEPHERD PKWY, SUITE 1, SHEPHERDSVILLE, KY 40165-6640
(502) 543-1055
(502) 543-1052
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3005033
KY
363LF0000X
Family Nurse Practitioner
5033P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000573918
ANTHEM
KY
01
000000765758
ANTHEM-NCMA
KY
01
114762
SIHO - NCMA
KY
05
201150490
IN
01
50037753
PASSPORT - NCMA
KY
05
7100062660
KY
Enumeration date
11/02/2006
Last updated
07/12/2016
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