National Provider Identifier Database

SHONNA BACK, NURSE PRACTITIONER – NPI #1376734442
Family


Contact Information

SHONNA BACK, NURSE PRACTITIONER
130 PAVILION PKWY
NEWPORT, KY41071-2998
Phone: 859-652-7203
Fax: 859-652-7204
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for SHONNA BACK

NPI Number 1376734442
Credentials NURSE PRACTITIONER
Entity Individual
Enumeration date 08/05/2007
Last updated 07/08/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • KY License #: 3006274
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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