Provider Demographics
NPI:1417613993
Name:SHIRCLIFFE, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:SHIRCLIFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 S WINCHESTER ACRES RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-1635
Mailing Address - Country:US
Mailing Address - Phone:502-727-7271
Mailing Address - Fax:
Practice Address - Street 1:3208 S WINCHESTER ACRES RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-1635
Practice Address - Country:US
Practice Address - Phone:502-727-7271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator