Organization
NP PRIMARY CARE CLINICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON T SHUFFITT DNP, APRN (PRESIDENT & CEO)
(270) 282-7102
Entity
Organization
Contact information
Practice address
1214 HERRINGTON ST, BOWLING GREEN, KY 42104-3235
(270) 282-7201
Mailing address
1214 HERRINGTON ST, BOWLING GREEN, KY 42104-3235
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3005814
KY
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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