Kellison, Shawnee Lynn

Kellison, Shawnee Lynn is an individual health care provider with primary practice located at 700 W Jefferson St , Kirksville MO 63501-1441. She recently has only one registered license in Nursing Service Providers / General Practice, which is considered as her primary health care specialty. Kellison, Shawnee Lynn can be contacted via phone (660) 626-2191.

Contact Information

Primary practice address
700 W Jefferson St Kirksville MO 63501-1441
Phone: (660) 626-2191
Fax: (660) 626-2396
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X 113721 Missouri

Profile Details

NPI number 1063495463
LBN Legal business name Kellison, Shawnee Lynn
Credentials RNBCFNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2005
Last updated Jan 21st, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063495463 NPPES
Missouri Other 501218200 MEDICAID GROUP #
Missouri MEDICAID 428713812 MEDICAID GROUP #
Missouri Other DG4290 MEDICAID GROUP #
Missouri Other 000014853 MEDICAID GROUP #
Missouri Other P00435145 MEDICAID GROUP #

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