Basic Information
| Provider Information | |||||||||
| NPI: | 1740625227 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHENAULT | ||||||||
| FirstName: | SHELLEY | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1720 NICHOLASVILLE RD STE 702 | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405031489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592648811 | ||||||||
| FaxNumber: | 8592648822 | ||||||||
| Practice Location | |||||||||
| Address1: | 1720 NICHOLASVILLE RD STE 702 | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405031489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592648811 | ||||||||
| FaxNumber: | 8592648822 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2013 | ||||||||
| LastUpdateDate: | 02/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN358629 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 367A00000X | APRN358629 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367A00000X | 3013784 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.