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General NPI Number Information
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NPI Number | 1194310045
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Entity Type | Individual
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Provider Name | SHANNON DANIELLE ROBINSON
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Gender | Female
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 50 MEDPARK DR STE 3
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City | SOMERSET
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State | KY
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Zip | 42503-4730
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Country | US
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Telephone | 606-531-4100
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Fax | 606-220-2116
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Provider Business Mailing Address
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Address Line | 108 W MAPLE AVE STE 1
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City | LONDON
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State | KY
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Zip | 40741-1767
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Country | US
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Telephone | 636-577-5592
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4035082
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License Number State | KY
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