Individual
SHANNON EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
308 LUZERNE, TABLE ROCK, NE 68447
(816) 654-5138
Mailing address
510 8TH ST, TABLE ROCK, NE 68447-3021
(816) 654-5138
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
372500000X
Chore Provider
—
NE
372600000X
Adult Companion
—
NE
3747P1801X
Personal Care Attendant
—
NE
Other
Enumeration date
01/26/2022
Last updated
02/12/2025
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