Individual
LYNN SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
816 N 22ND ST, PADUCAH, KY 42001-3017
(615) 738-1209
Mailing address
PO BOX 291212, NASHVILLE, TN 37229-1212
(615) 738-1209
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
618133600
DEEOIC PROVIDER
KY
Enumeration date
08/05/2014
Last updated
08/05/2014
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