Individual
ZACHARY SHANE CAVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN PMHNP-BC
Contact information
Practice address
645 INTERSTATE DR, GRAYSON, KY 41143-1704
(606) 474-0669
Mailing address
909 LYNWOOD ST, RACELAND, KY 41169-1430
(606) 371-4572
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1162592
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4021140
KY
Other
Enumeration date
05/09/2024
Last updated
06/24/2024
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