Provider Demographics
NPI:1710612254
Name:SHINN, JOSEPH JACOB (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JACOB
Last Name:SHINN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:JAKE
Other - Middle Name:
Other - Last Name:SHINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4463 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-3444
Mailing Address - Country:US
Mailing Address - Phone:765-337-3071
Mailing Address - Fax:
Practice Address - Street 1:2301 HOLMES ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2640
Practice Address - Country:US
Practice Address - Phone:816-404-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029290A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist