Most Relevant Information
Provider Data
| NPI Number: | 1003569435 |
| Provider Name: | SHELBY VICTORIA COFER CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 3017259 |
Most Important Dates
| Enumeration Date: | 01/26/2022 |
| Last Updated: | 02/28/2022 |
Provider Practice Location
530 S JACKSON ST
LOUISVILLE
KY
402021675
Practice Location Phone/Fax
| Phone: | 5025623000 |
| Fax: |
Provider Mailing Location
PO BOX 909
LOUISVILLE
KY
402010909
Provider Mailing Phone/Fax
| Phone: | 5025880328 |
| Fax: |