MEDICARE: MRS. SHANA LAIAN GEDDINS FNP

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
1	363L00000X	Nurse Practitioner	1496521092	KS

General Provider Information

NPI Number	:	1154309706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHANA LAIAN GEDDINS FNP

Provider Business Mailing Address
First Line	:	1804 NW 63RD TERRACE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151
Country	:	US
Telephone Number	:	816-746-4438
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 N 12TH ST
Second Line	:	SUITE 400
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-5161
Country	:	US
Telephone Number	:	816-922-7600
Fax Number	:	816-448-2904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	04/20/2011

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