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General NPI Number Information
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NPI Number | 1881449908
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Entity Type | Individual
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Provider Name | AMY M. SHAW
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Gender | Female
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 306 W MAIN ST STE 512
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City | FRANKFORT
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State | KY
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Zip | 40601-1840
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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Provider Business Mailing Address
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Address Line | 312 S 4TH ST STE 700
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City | LOUISVILLE
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State | KY
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Zip | 40202-3046
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4016107
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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 | 4016107
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License Number State | KY
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