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General NPI Number Information
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NPI Number | 1689954232
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Entity Type | Organization
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Legal Business Name | MOREHEAD STATE UNIVERSITY
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 112 ALLIE YOUNG HALL
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City | MOREHEAD
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State | KY
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Zip | 40351-1684
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Country | US
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Telephone | 606-783-2885
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Fax | 606-783-9106
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Provider Business Mailing Address
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Address Line | 112 ALLIE YOUNG HALL
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City | MOREHEAD
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State | KY
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Zip | 40351-1684
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Country | US
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Telephone | 606-783-2885
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Fax | 606-783-9106
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. SHANNON SMITH STEPHENS
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Credential | DNP, APRN
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Telephone | 606-783-2123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0668
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 03203
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3796P
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3002104
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | KY
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Taxonomy #7
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | KY
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Taxonomy #8
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3004857
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License Number State | KY
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