Healthcare Provider Details

I. General information

NPI: 1811053747
Provider Name (Legal Business Name): GAIL ANN SHAFTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 09/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 CLAY EDWARDS DR SUITE 300
NORTH KANSAS CITY MO
64116-3276
US

IV. Provider business mailing address

9411 N OAK TRFY SUITE LL1
KANSAS CITY MO
64155-2233
US

V. Phone/Fax

Practice location:
  • Phone: 816-221-6750
  • Fax: 816-221-7280
Mailing address:
  • Phone: 816-436-7072
  • Fax: 816-436-2743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number093805
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number45745
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number093805
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: