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Contact Information

SHONNA BACK, NURSE PRACTITIONER
130 PAVILION PKWY
NEWPORT, KY41071-2998
 Phone: 859-652-7203
 Fax: 859-652-7204
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SHONNA BACK · (Female)

NPI # 1376734442
Status Active
Credentials NURSE PRACTITIONER
Entity Individual
Enumeration date 08/05/2007
Last updated 07/08/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • KY License # 3006274
Hospital affiliation(s) Not Available
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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