| Mrs Marissa Eusebio Shih, APRN | |
|
115 Rockwood Ln, Hazard, KY 41701-9415 | |
| (606) 436-5761 | |
| (606) 436-5797 |
| Full Name | Mrs Marissa Eusebio Shih |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 115 Rockwood Ln, Hazard, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629165956 | NPI | - | NPPES |
| 61-0991301 | Other | KY | CORPORATION TAX ID |
| 78004215 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 3180P (Kentucky) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 3003180 (Kentucky) | Primary |
| Entity Name | Kentucky River Community Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528017142 PECOS PAC ID: 3870481229 Enrollment ID: O20040308000506 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Marissa Eusebio Shih, APRN 115 Rockwood Ln, Hazard, KY 41701-9415 Ph: (606) 436-5761 | Mrs Marissa Eusebio Shih, APRN 115 Rockwood Ln, Hazard, KY 41701-9415 Ph: (606) 436-5761 |
Jonathan D Combs, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1908 N Main St, Hazard, KY 41701 Phone: 606-439-2662 |
Sydney Roark, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Medical Center Dr, Hazard, KY 41701 Phone: 606-439-3952 |
Janie C Thompson, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 279 E Main St, Hazard, KY 41701 Phone: 606-487-9505 Fax: 606-436-0071 |
Trena Preston, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 181 Roy Campbell Dr, Hazard, KY 41701 Phone: 606-487-7955 Fax: 606-487-7949 |
Chelsea Walker, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 210 Black Gold Blvd Ste 106, Hazard, KY 41701 Phone: 606-436-0711 Fax: 606-436-0848 |
Kristen Rae Fugate, RN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 101 Airport Gardens Rd Ste 200, Hazard, KY 41701 Phone: 606-629-3121 |
Mrs. Robetta Melaine Baker, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 311 Roy Campbell Dr, Hazard, KY 41701 Phone: 606-487-0776 Fax: 606-487-0777 |