Provider Demographics
NPI:1366015471
Name:FLAX, SHANSY (CBD)
Entity Type:Individual
Prefix:
First Name:SHANSY
Middle Name:
Last Name:FLAX
Suffix:
Gender:F
Credentials:CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:RANSOM
Mailing Address - State:KS
Mailing Address - Zip Code:67572-0193
Mailing Address - Country:US
Mailing Address - Phone:785-731-1125
Mailing Address - Fax:
Practice Address - Street 1:221 S NEW JERSEY AVE
Practice Address - Street 2:
Practice Address - City:RANSOM
Practice Address - State:KS
Practice Address - Zip Code:67572-7015
Practice Address - Country:US
Practice Address - Phone:785-731-1125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty