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NPI Code Detail

MEDICARE: MS. SANDRA KAY SHUNK LPN

MEDICARE: MS. SANDRA KAY SHUNK LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse2015022174MO

General Provider Information

NPI Number : 1124206305
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SANDRA KAY SHUNK LPN
Provider Business Mailing Address
First Line : 900 E. LA HARPE ST
Second Line :
City : KIRKSVILLE
State : MO
Zip : 63501-4520
Country : US
Telephone Number : 680-665-1962
Fax Number : 660-665-3989
Provider Business Practice Location Address
First Line : 1628 OKLAHOMA AVENUE
Second Line :
City : TRENTON
State : MO
Zip : 64683-2565
Country : US
Telephone Number : 660-359-4600
Fax Number : 660-359-4286
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2008
Last Update Date : 09/08/2015

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