Individual
BLAKE R SHINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2660 SW 3RD ST, TOPEKA, KS 66606-2442
(785) 270-8880
(785) 270-8881
Mailing address
2660 SW 3RD ST, TOPEKA, KS 66606-2442
(785) 270-8880
(785) 270-8881
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01925
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002411
MEDICARE PTAN
KS
05
—
201141610A
—
KS
Enumeration date
05/25/2016
Last updated
05/04/2026
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