Provider Demographics
NPI:1659751238
Name:HUGGANS, SHAWNA RAE (NP)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:RAE
Last Name:HUGGANS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:CONCORDIA
Mailing Address - State:KS
Mailing Address - Zip Code:66901-3923
Mailing Address - Country:US
Mailing Address - Phone:785-243-4272
Mailing Address - Fax:785-243-4275
Practice Address - Street 1:1100 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:CONCORDIA
Practice Address - State:KS
Practice Address - Zip Code:66901-3923
Practice Address - Country:US
Practice Address - Phone:785-243-4272
Practice Address - Fax:785-243-4275
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS76818363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201139110AMedicaid