Individual
SHANE AUSTIN STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACAGNP
Contact information
Practice address
6000 HOSPITAL DR, HANNIBAL, MO 63401-6887
(573) 248-5211
(573) 248-5210
Mailing address
6000 HOSPITAL DR, HANNIBAL, MO 63401-6887
(573) 248-5211
(573) 248-5210
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2026001767
MO
Other
Enumeration date
01/17/2026
Last updated
03/12/2026
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