Individual
SHANNON RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1800 WALNUT ST APT 1307, KANSAS CITY, MO 64108-2796
(913) 485-5494
Mailing address
1800 WALNUT ST APT 1307, KANSAS CITY, MO 64108-2796
(913) 485-5494
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2025046834
MO
Other
Enumeration date
11/03/2025
Last updated
11/03/2025
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