MEDICARE: MR. SHAWN PATRICK STANLEY BC-HIS

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	237700000X	Hearing Instrument Specialist	2008020655	MO

General Provider Information

NPI Number	:	1205016565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHAWN PATRICK STANLEY BC-HIS

Provider Business Mailing Address
First Line	:	27 NW BARRY RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2728
Country	:	US
Telephone Number	:	816-308-6873
Fax Number	:	816-308-6873

Provider Business Practice Location Address
First Line	:	27 NW BARRY RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2728
Country	:	US
Telephone Number	:	816-308-6873
Fax Number	:	816-308-6873

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

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	09/27/2012

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