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General NPI Number Information
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NPI Number | 1518213776
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Entity Type | Individual
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Provider Name | SAMANTHA BROOKE SHELL APRN
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Gender | Female
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 324 W MAPLE AVE
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City | LANCASTER
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State | KY
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Zip | 40444-1171
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Country | US
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Telephone | 859-719-6016
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Fax | 606-645-1776
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Provider Business Mailing Address
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Address Line | PO BOX 1535
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City | BARBOURVILLE
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State | KY
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Zip | 40906-5535
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Country | US
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Telephone | 606-599-0077
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Fax | 606-645-1776
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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 | 3007551
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License Number State | KY
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