Individual
STACEY ELIZABETH SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4330 WORNALL RD STE 2000, KANSAS CITY, MO 64111-5939
(816) 931-1883
(816) 931-7714
Mailing address
901 E 104TH ST, MAILSTOP 400S, KANSAS CITY, MO 64131-2705
(816) 599-9261
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019010062
MO
363LF0000X
Family Nurse Practitioner
5378919
KS
Other
Enumeration date
08/21/2019
Last updated
12/06/2019
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