Provider Demographics
NPI:1235576125
Name:HOSEY, NICHOLAS SHAYNE
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:SHAYNE
Last Name:HOSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:MS 1045
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-1559
Mailing Address - Fax:913-945-6403
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:MS 1045
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-1559
Practice Address - Fax:913-945-6403
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9408195207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine