Individual
CARLY SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4880 NE GOODVIEW CIR, LEES SUMMIT, MO 64064-1996
(816) 478-4200
(816) 875-2598
Mailing address
3340 NE RALPH POWELL RD STE B, LEES SUMMIT, MO 64064-2368
(816) 478-4200
(816) 875-2598
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2019026180
MO
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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