Provider Demographics
NPI:1508141946
Name:NP CAREGIVERS, LLC
Entity Type:Organization
Organization Name:NP CAREGIVERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WILDER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:606-273-0958
Mailing Address - Street 1:120 GILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:KY
Mailing Address - Zip Code:40823-1906
Mailing Address - Country:US
Mailing Address - Phone:606-273-0958
Mailing Address - Fax:
Practice Address - Street 1:19101 N US HIGHWAY 119
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:KY
Practice Address - Zip Code:40823-1906
Practice Address - Country:US
Practice Address - Phone:606-589-5421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-17
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1086716314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility