Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shonna Back, NURSEPRACTITIONER

Individual provider Family Nurse Practitioner · NPI 1376734442

Shonna Back, NURSEPRACTITIONER is a Nurse Practitioner in Newport, Kentucky. Qualified in 2006, 20 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
20
Licensed in
KY
In the registry since
2007

Practice location Address checks out

130 Pavilion Pkwy
Newport, KY 41071-2998
Phone: (859) 652-7203
Fax: (859) 652-7204
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3955 Alexandria Pike, Cold Spring, KY 41076-2027 — (859) 442-8700

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 3006274 (KY)

Record details

NPI number1376734442
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedAugust 5, 2007
Last updated in NPPESJuly 8, 2022
Certification dateJune 7, 2022
Mailing address1239 Woodland Dr Ste 108, Elizabethtown, KY 42701-2770

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Newport