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General NPI Number Information
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NPI Number | 1255011524
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Entity Type | Individual
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Provider Name | KAELIN CHERISE SHAY
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Gender | Female
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Dates
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Enumeration Date | 07/21/2023
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 1220 MISSOURI AVE
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3725
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Country | US
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Telephone | 812-283-2217
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 1163315
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4029189
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 71016336A
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License Number State | IN
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