Individual
SHANNON S MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
205 W R D MIZE RD, SUITE 304, BLUE SPRINGS, MO 64014-2518
(816) 655-0125
(816) 228-1156
Mailing address
205 W R D MIZE RD, SUITE 304, BLUE SPRINGS, MO 64014-2518
(816) 655-0125
(816) 228-1156
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
153357
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000645
FAMILY HEALTH PARTNERS
—
01
—
045847
FAMILY HEALTH PARTNERS
—
Enumeration date
07/08/2005
Last updated
07/08/2007
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