Healthcare Provider Details

I. General information

NPI: 1194632638
Provider Name (Legal Business Name): SHELBY DAVIS APRN, CNM
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 KINGS DAUGHTERS DR STE 301
FRANKFORT KY
40601-6564
US

IV. Provider business mailing address

PO BOX 1080
BURKESVILLE KY
42717-1080
US

V. Phone/Fax

Practice location:
  • Phone: 502-227-2999
  • Fax:
Mailing address:
  • Phone: 270-858-6655
  • Fax: 270-858-4027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number4058953
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: