Individual
SHAWNA L. KAUFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12955 SHELBYVILLE RD STE 2, LOUISVILLE, KY 40243
(502) 245-4301
(502) 244-5829
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46193
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000829906
ANTHEM - NCMA
KY
01
—
000000830890
ANTHEM - NICC
KY
01
—
149534
SIHO - NICC
KY
01
—
149563
SIHO - NCMA
KY
01
—
50065676
PASSPORT
KY
05
—
7100179250
—
KY
Enumeration date
03/25/2010
Last updated
05/28/2019
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