Individual
MRS. MARISSA EUSEBIO SHIH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
(606) 436-5797
Mailing address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
(606) 436-5797
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3180P
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3003180
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61-0991301
CORPORATION TAX ID
KY
05
—
78004215
—
KY
Enumeration date
10/06/2006
Last updated
09/19/2023
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