Provider Demographics
NPI:1336105790
Name:SHUPE, INA (RN CS CAP UHCNS)
Entity Type:Individual
Prefix:
First Name:INA
Middle Name:
Last Name:SHUPE
Suffix:
Gender:F
Credentials:RN CS CAP UHCNS
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:10918 ELM AVENUE
Mailing Address - Street 2:CRITTENTON CHILDREN'S CENTER
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134
Mailing Address - Country:US
Mailing Address - Phone:816-765-6600
Mailing Address - Fax:816-767-4159
Practice Address - Street 1:10918 ELM AVENUE
Practice Address - Street 2:CRITTENTON CHILDREN'S CENTER
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134
Practice Address - Country:US
Practice Address - Phone:816-765-6600
Practice Address - Fax:816-767-4159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KSKS74239363LP0808X
MO057302363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health