Individual
SHANNON ELIZABETH CUMMINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4801 S CLIFF AVE STE 100, INDEPENDENCE, MO 64055-6954
(816) 478-1230
(816) 350-4585
Mailing address
4801 S CLIFF AVE STE 100, INDEPENDENCE, MO 64055-6954
(816) 478-1230
(816) 350-4585
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2019026756
MO
152W00000X
Optometrist
2105
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q00037687
PALMETTO GBA RAILROAD MEDICARE
—
Enumeration date
03/22/2019
Last updated
03/29/2021
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