Provider Demographics
NPI:1629523493
Name:SHOUSE, CARA MICHELLE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CARA
Middle Name:MICHELLE
Last Name:SHOUSE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:CARA
Other - Middle Name:MICHELLE
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:302 E CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6564
Mailing Address - Country:US
Mailing Address - Phone:620-231-8003
Mailing Address - Fax:620-231-8502
Practice Address - Street 1:302 E CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6564
Practice Address - Country:US
Practice Address - Phone:620-231-8003
Practice Address - Fax:620-231-8502
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS77356-061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily