SHONNA BACK (NPI# 1376734442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376734442 |
| Entity Type | Individual |
| Full Name | SHONNA BACK |
| Credential | NURSE PRACTITIONER |
| Practice Address |
130 Pavilion Pkwy Newport KY 41071-2998 |
| Mailing Address |
1239 Woodland Dr Ste 108 Elizabethtown KY 42701-2770 |
| Practice Telephone | 8596527203 |
| Practice Fax Number | 8596527204 |
| Mailing Telephone | 2707654535 |
| Mailing Fax Number | 2707631901 |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2014-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3006274 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
130 PAVILION PKWY |
| City | NEWPORT |
| State | KY |
| Zip Code | 41071-2998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798891 | Alaina Renee Camblin | Pharmacist | 130 Pavilion Pkwy, Newport, KY 41071-2998 | 2020-10-21 |
| 1902264526 | Daniel Carver | Pharmacist | 130 Pavilion Pkwy, Newport, KY 41071-2998 | 2016-02-10 |
| 1982096251 | Molly Lucas | Pharmacist | 130 Pavilion Pkwy, Newport, KY 41071-2998 | 2015-02-24 |
| 1558753996 | Kelly Holloran | Pharmacist | 130 Pavilion Pkwy, Newport, KY 41071-2998 | 2015-02-23 |
| 1881086312 | Kurt Fields | Pharmacist | 130 Pavilion Pkwy, Newport, KY 41071-2998 | 2015-02-20 |
| 1265822043 | Sarah C Rank | Nurse Practitioner | 130 Pavilion Pkwy, Newport, KY 41071-2998 | 2015-01-30 |
| 1265855241 | Kiosk Medicine Kentucky LLC | Nurse Practitioner | 130 Pavilion Pkwy, Newport, KY 41071-2998 | 2014-01-28 |
| 1205268190 | Sarah Elizabeth Blackburn | Nurse Practitioner | 130 Pavilion Pkwy, Newport, KY 41071-2998 | 2013-08-02 |
| 1386987568 | Ashley Renee Roeding | Nurse Practitioner | 130 Pavilion Pkwy, Newport, KY 41071-2998 | 2013-04-05 |
| 1912292277 | Rebecca Robinson | Pharmacist | 130 Pavilion Pkwy, Newport, KY 41071-2998 | 2011-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528598240 | Drew Austin Rappaport | Dentist | 70 Carothers Rd, Newport, KY 41071 | 2017-06-14 |
| 1811443435 | Marcus E. Mckinney | Pharmacist | 100 Aqua Way, Newport, KY 41071 | 2016-09-01 |
| 1730306754 | Benjamin Michael Anderson | Psychologist | 1400 Grand Avenue, Newport, KY 41071 | 2007-04-19 |
| 1437288065 | Douglas K Braun | Dentist | 40 E 9th St, Newport, KY 41071 | 2007-03-02 |
| 1952445017 | Therapeutic Collabortive | Social Worker | 525 Licking Pike, Wilder, KY 41071 | 2007-02-20 |
| 1215078407 | Holly Ann Eary | Counselor | 519 Licking Pk, Wilder, KY 41071 | 2007-02-09 |
| 1790839819 | James John Otrembiak | Pediatrics | 525 Alexandria Pike Ste 320, Southgate, KY 41071 | 2007-01-23 |
| 1326047903 | Stephen F Mielech | Podiatrist | 525 Alexandria Pike, Southgate, KY 41071 | 2005-07-18 |
| 1033737085 | Ashley Ryan | Nurse Practitioner | 215 E. 11th St., Newport, KY 41071 | 2020-07-07 |
| 1548733066 | Summt Medical Group, Inc | Clinic/Center | 1400 Grand Avenue, Newport, KY 41071 | 2019-01-08 |
| Find all providers in zip 41071 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679170922 | Katrina Marie Prive | Nurse Practitioner | 799 Salem View Heights, Newport, VT 05855 | 2020-10-08 |
| 1699328765 | Kristin Renae Hickman | Nurse Practitioner | 434 4th St Ste 310, Newport, TN 37821-3735 | 2019-07-18 |
| 1467919423 | Sara Gdowski | Nurse Practitioner | 9083 Maple Ridge Dr, Newport, MI 48166-9285 | 2019-02-26 |
| 1639633191 | Kristen Renae Tabor | Nurse Practitioner | 1532 Sherwood Dr, Newport, TN 37821-7124 | 2019-01-29 |
| 1447749437 | Amie Burrow | Nurse Practitioner | 300 Corrections Drive, Newport, AR 72112 | 2018-05-04 |
| 1871097212 | Amanda Therese Wuebben | Nurse Practitioner | 4388 Partridge Ln, Newport, MI 48166-9189 | 2018-03-21 |
| 1497261093 | Tiffany Paige Holcomb | Nurse Practitioner | 300 Corrections Dr, Newport, AR 72112-8008 | 2017-12-18 |
| 1386165108 | Maureen Anne Burns | Nurse Practitioner | 612 Grandview Ave, Newport, KY 41071-2847 | 2017-07-01 |
| 1235684184 | Meghan Hart | Nurse Practitioner | 756 Cosby Hwy, Newport, TN 37821-3455 | 2016-08-22 |
| 1215329784 | Jessica Manning | Nurse Practitioner | 216 Hedrick Dr, C/o Cocke County High School, Newport, TN 37821-2906 | 2015-02-20 |
| Find all providers in NEWPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.