Provider Demographics
NPI:1154309706
Name:GEDDINS, SHANA LAIAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHANA
Middle Name:LAIAN
Last Name:GEDDINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 NW 63RD TERRACE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151
Mailing Address - Country:US
Mailing Address - Phone:816-746-4438
Mailing Address - Fax:
Practice Address - Street 1:21 N 12TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-5161
Practice Address - Country:US
Practice Address - Phone:816-922-7600
Practice Address - Fax:816-448-2904
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1496521092363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner