MRS. MARISSA EUSEBIO SHIH A.P.R.N. NPI 1629165956

NPI Information

NPI: 1629165956
Provider Name: MRS. MARISSA EUSEBIO SHIH, A.P.R.N.
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
115 ROCKWOOD LN
HAZARD, KY
ZIP 41701
Phone: (606) 436-5761
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MRS. Marissa Eusebio Shih, A.P.R.N. is a psychiatric/mental health nurse practitioner in Hazard, KY with 25 years of experience. MRS. Marissa Eusebio Shih, A.P.R.N. NPI is 1629165956. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

115 ROCKWOOD LN
HAZARD, KY
ZIP 41701-415
Phone: (606) 436-5761
Fax: (606) 436-5797

The NPI 1629165956 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/6/2006 and was last updated on 9/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	3180P	KENTUCKY	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	3003180	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	78004215	MEDICAID	KENTUCKY
2	61-0991301	OTHER	KENTUCKY	CORPORATION TAX ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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