Healthcare Provider Details

I. General information

NPI: 1659968220
Provider Name (Legal Business Name): KAYLA SHREWSBURY RN/BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N ORANGE ST
BUTLER MO
64730-1325
US

IV. Provider business mailing address

501 N ORANGE ST
BUTLER MO
64730-1325
US

V. Phone/Fax

Practice location:
  • Phone: 660-679-6108
  • Fax: 660-679-6022
Mailing address:
  • Phone: 660-679-6108
  • Fax: 660-679-6022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number2009008218
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: