Provider Demographics
NPI:1659968220
Name:SHREWSBURY, KAYLA (RN/BSN)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:SHREWSBURY
Suffix:
Gender:F
Credentials:RN/BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:MO
Mailing Address - Zip Code:64730-1325
Mailing Address - Country:US
Mailing Address - Phone:660-679-6108
Mailing Address - Fax:660-679-6022
Practice Address - Street 1:501 N ORANGE ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:MO
Practice Address - Zip Code:64730-1325
Practice Address - Country:US
Practice Address - Phone:660-679-6108
Practice Address - Fax:660-679-6022
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090082182083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine