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NPI Code Detail

MEDICARE: SHAUN MCKINNEY

MEDICARE:   SHAUN  MCKINNEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1275099053
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAUN MCKINNEY
Provider Business Mailing Address
First Line : 209 EUCLID AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63119-1613
Country : US
Telephone Number : 636-250-8395
Fax Number :
Provider Business Practice Location Address
First Line : 209 EUCLID AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63119-1613
Country : US
Telephone Number : 636-250-8395
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2019
Last Update Date : 02/16/2019

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Directions to “ SHAUN MCKINNEY ” Practice Location

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