Healthcare Provider Details

I. General information

NPI: 1134657117
Provider Name (Legal Business Name): KRISTEN SHAVAUGHN STAMPEHL NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN SHAVAUGHN HONEYCUTT NP-C

II. Dates (important events)

Enumeration Date: 06/02/2017
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304A E 4TH ST
ELDON MO
65026-1808
US

IV. Provider business mailing address

304A E 4TH ST
ELDON MO
65026-1808
US

V. Phone/Fax

Practice location:
  • Phone: 573-392-5654
  • Fax: 573-392-5692
Mailing address:
  • Phone: 573-392-5654
  • Fax: 573-392-5692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2019000617
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209015980
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: