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NPI Code Detail

MEDICARE: SHELBY SMALLWOOD

MEDICARE: SHELBY SMALLWOOD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse4051160KY

General Provider Information

NPI Number : 1518810811
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY SMALLWOOD
Provider Business Mailing Address
First Line : PO BOX 790
Second Line :
City : ASHLAND
State : KY
Zip : 41105-0790
Country : US
Telephone Number : 606-329-8588
Fax Number :
Provider Business Practice Location Address
First Line : 3701 LANDSDOWNE DR
Second Line :
City : ASHLAND
State : KY
Zip : 41102-5422
Country : US
Telephone Number : 606-329-8588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2026
Last Update Date : 02/17/2026

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Directions to “ SHELBY SMALLWOOD ” Practice Location

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