Basic Information
| Provider Information | |||||||||
| NPI: | 1770933046 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BILLER | ||||||||
| FirstName: | SHELBY | ||||||||
| MiddleName: | MEISNER | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 87 STRIKE HOUND CT | ||||||||
| Address2: | |||||||||
| City: | FISHERVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 400236462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026930197 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1203 AMERICAN GREETING CARD RD | ||||||||
| Address2: | |||||||||
| City: | CORBIN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6065287010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2016 | ||||||||
| LastUpdateDate: | 10/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 3010371 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 7100419540 | 05 | KY | MEDICAID |