Nelson, Shaun

Nelson, Shaun is an individual health care provider with primary practice located at 120 Executive Park , Louisville KY 40207-4201. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Nelson, Shaun can be contacted via phone (502) 855-7200.

Contact Information

Primary practice address
120 Executive Park Louisville KY 40207-4201
Phone: (502) 855-7200
Fax: (502) 855-7201
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA842 Kentucky

Profile Details

NPI number 1104811603
LBN Legal business name Nelson, Shaun
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2005
Last updated Apr 14th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104811603 NPPES
Indiana MEDICAID 300040820
Indiana MEDICAID 95004735
Indiana Other 100508KYIP
Indiana Other 2268718
Indiana Other 000001408313
Indiana Other CS2026900168

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