Provider Demographics
NPI:1831297043
Name:SHOMAN, STACEY PAGE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:PAGE
Last Name:SHOMAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12541 FOSTER ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2630
Mailing Address - Country:US
Mailing Address - Phone:913-906-0900
Mailing Address - Fax:913-906-0909
Practice Address - Street 1:12541 FOSTER ST
Practice Address - Street 2:SUITE 260
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2630
Practice Address - Country:US
Practice Address - Phone:913-906-0900
Practice Address - Fax:913-906-0909
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO148213363LP0200X
KS45904363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics