Individual
BRENDA SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9100 W 74TH ST, MERRIAM, KS 66204-4004
(913) 632-9100
(913) 632-9159
Mailing address
9100 W 74TH ST, MERRIAM, KS 66204-4004
(913) 632-9100
(913) 632-9159
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
2005007820
MO
207VX0201X
Gynecologic Oncology Physician
Primary
431352
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200459402
—
MO
01
—
2231144
UHC
—
01
—
35478013
BCBS OF KC
—
01
—
7727356
AETNA
—
01
—
77780
HEALTHCARE USA
—
01
—
P00274849
RAILROAD MEDICARE
—
Enumeration date
05/26/2006
Last updated
06/24/2024
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