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NPI Code Detail

MEDICARE: SARA SHAW NP

MEDICARE: SARA SHAW NP
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
1363L00000XNurse Practitioner76822KS

General Provider Information

NPI Number : 1396125159
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA SHAW NP
Provider Business Mailing Address
First Line : 16240 FOSTER ST
Second Line :
City : STILWELL
State : KS
Zip : 66085-8418
Country : US
Telephone Number : 913-894-8500
Fax Number :
Provider Business Practice Location Address
First Line : 4625 LINDELL BLVD FL 2
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-3739
Country : US
Telephone Number : 914-919-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2015
Last Update Date : 06/26/2026

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Directions to “ SARA SHAW NP” Practice Location

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