Healthcare Provider Details

I. General information

NPI: 1285922856
Provider Name (Legal Business Name): SHAWN N MCCLURE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAWN N BEAMAN

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 NW VICTORIA DR
LEES SUMMIT MO
64086-4700
US

IV. Provider business mailing address

320 NW VICTORIA DR
LEES SUMMIT MO
64086-4700
US

V. Phone/Fax

Practice location:
  • Phone: 816-265-6150
  • Fax:
Mailing address:
  • Phone: 816-265-6150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2011017808
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2207
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: