Provider Demographics
NPI:1346334117
Name:EVANS, SHAWNA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAWNA
Middle Name:LYNN
Last Name:EVANS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18504 E TRUMAN RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64056-2343
Mailing Address - Country:US
Mailing Address - Phone:816-796-1621
Mailing Address - Fax:816-796-1621
Practice Address - Street 1:635 E 23RD ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-1504
Practice Address - Country:US
Practice Address - Phone:816-796-1621
Practice Address - Fax:816-796-1621
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000144181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor