Individual
MRS. SHAWN KATHLEEN ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2300 CHAMBER CENTER DR, LAKESIDE PARK, KY 41017-1686
(859) 341-3114
(859) 578-2156
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25375
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000052213
ANTHEM
KY
05
—
64253750
—
KY
Enumeration date
09/15/2006
Last updated
10/18/2022
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