Individual
SHANNA BISNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 N, KS-99, WESTMORELAND, KS 66549
(785) 457-2801
(512) 310-9228
Mailing address
105 N, KS-99, WESTMORELAND, KS 66549
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-01989
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031DG
BLUE CROSS BLUE SHIELD
—
05
—
0944746-02
—
TX
01
—
74-2745294
TAX ID
—
Enumeration date
07/15/2009
Last updated
03/04/2024
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