Individual
SHANNON NICHOLE BAISDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6130 HODGES DR, MISSION, KS 66205-3038
(913) 645-5675
Mailing address
6130 HODGES DR, MISSION, KS 66205-3038
(913) 645-5675
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
W46011
KS
224Y00000X
Clinical Exercise Physiologist
1180234454
—
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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