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Individual

JOHNNA C SHOWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-C

Contact information

Practice address
4915 NORTON HEALTHCARE BLVD STE 301, LOUISVILLE, KY 40241-2860
(502) 394-6460
(502) 394-6465
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010319
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001083714
ANTHEM PIN
05
300009605
IN
01
6043312
AETNA PIN
05
7100465120
KY
01
CS1811300243
CARESOURCE ID
Enumeration date
06/24/2016
Last updated
09/07/2021
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