Individual
SHALEY KNICKERBOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-7400
Mailing address
514 FLAME WAY, BALDWIN CITY, KS 66006-4168
(785) 443-0834
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
138424
KS
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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