Healthcare Provider Details

I. General information

NPI: 1649655374
Provider Name (Legal Business Name): SHAWNA DOANE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 07/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 MORGAN AVE
DOWNS KS
67437-1623
US

IV. Provider business mailing address

823 MORGAN AVE
DOWNS KS
67437-1623
US

V. Phone/Fax

Practice location:
  • Phone: 785-454-6614
  • Fax:
Mailing address:
  • Phone: 785-454-6614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-14449
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: