Individual
AMANDA JEAN SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
101 ORCHARD DR, NICHOLASVILLE, KY 40356-2690
(859) 881-4288
(859) 881-4388
Mailing address
215 E 11TH ST, NEWPORT, KY 41071-2203
(859) 655-6100
(859) 655-6221
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3018068
KY
Other
Enumeration date
07/22/2022
Last updated
09/12/2022
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