Healthcare Provider Details

I. General information

NPI: 1588968226
Provider Name (Legal Business Name): SHELLEY L ESTES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date: 08/31/2022
Reactivation Date: 10/04/2022

III. Provider practice location address

3101 RICHMOND RD STE 190
LEXINGTON KY
40509-1525
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 200
MIAMI FL
33126-3168
US

V. Phone/Fax

Practice location:
  • Phone: 859-309-7613
  • Fax: 877-722-0592
Mailing address:
  • Phone: 844-630-0700
  • Fax: 877-374-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number3018312
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3018312
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: