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Individual

HALEY RENEE SHANKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
800 ROSE ST FL 2, LEXINGTON, KY 40536-0001
(859) 562-1085
(859) 257-5152
Mailing address
900 SOUTH LIMESTONE, LEXINGTON, KY 40536-0001

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3327
KY
363A00000X
Physician Assistant
TC011
KY
363AM0700X
Medical Physician Assistant
PA3327
KY
363AM0700X
Medical Physician Assistant
TC011
KY
363AS0400X
Surgical Physician Assistant
PA3327
KY
363AS0400X
Surgical Physician Assistant
TC011
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/19/2023
Last updated
01/10/2024
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