Provider Demographics
NPI:1326680075
Name:SHULL, SHAUGHNESSEY
Entity Type:Individual
Prefix:
First Name:SHAUGHNESSEY
Middle Name:
Last Name:SHULL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7613 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2346
Mailing Address - Country:US
Mailing Address - Phone:913-617-0633
Mailing Address - Fax:
Practice Address - Street 1:7613 HAYES ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-2346
Practice Address - Country:US
Practice Address - Phone:913-617-0633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy