Individual
SHAWN MATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0440
(573) 329-0879
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0440
(573) 329-0879
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
154938
MO
Other
Enumeration date
08/25/2010
Last updated
02/20/2025
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