Individual
MR. SHAWN KENNETH STUTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
1580 W COLUMBIA ST, FARMINGTON, MO 63640-3512
(573) 760-1365
Mailing address
1250 HIGHWAY 221, IRONTON, MO 63650-9155
(573) 315-9706
(573) 315-9706
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2011017944
MO
363LF0000X
Family Nurse Practitioner
2018030312
MO
363LF0000X
Family Nurse Practitioner
A162766
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G181662
IA
Other
Enumeration date
01/04/2019
Last updated
09/25/2025
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