Individual
MRS. FARAH LYNN SHADDIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, PMHNP-BC
Contact information
Practice address
401 CHURCH ST UNIT 791, O FALLON, MO 63366-6506
(636) 388-4170
(636) 306-4267
Mailing address
PO BOX 791, O FALLON, MO 63366-0791
(636) 388-4170
(636) 306-4267
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1097292
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2020019555
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
202114964NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209024820
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
259430
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3015935
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
53-81140-101
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95039174
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP61418023
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F408156
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
G161807
IA
Other
Enumeration date
07/05/2020
Last updated
04/08/2026
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