Provider Demographics
NPI:1588197982
Name:SHUKER, ALICIA M (FNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:SHUKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:M
Other - Last Name:FERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 CARONDELET DR
Mailing Address - Street 2:PROVIDER ENROLLMENT/MEDICAL STAFF OFFICE
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114
Mailing Address - Country:US
Mailing Address - Phone:816-943-5744
Mailing Address - Fax:
Practice Address - Street 1:930 CARONDELET DR
Practice Address - Street 2:STE 201
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114
Practice Address - Country:US
Practice Address - Phone:816-389-6100
Practice Address - Fax:816-389-6150
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily