Basic Information
| Provider Information | |||||||||
| NPI: | 1750702916 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WINCHESTER | ||||||||
| FirstName: | SHANA | ||||||||
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| Credential: | R.N., FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 801143 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641801143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733315583 | ||||||||
| FaxNumber: | 5733315079 | ||||||||
| Practice Location | |||||||||
| Address1: | 420 PIEDMONT AVE | ||||||||
| Address2: | |||||||||
| City: | PIEDMONT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 639571024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5732234233 | ||||||||
| FaxNumber: | 5732232136 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2013 | ||||||||
| LastUpdateDate: | 03/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | 2007004952 | MO | N | Nursing Service Providers | Registered Nurse | General Practice | 363LF0000X | 2014001567 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.