Provider Demographics
NPI:1841607900
Name:SANDERS, SHAYLA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHAYLA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12721 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:POLLOCK
Mailing Address - State:MO
Mailing Address - Zip Code:63560-2612
Mailing Address - Country:US
Mailing Address - Phone:660-265-5879
Mailing Address - Fax:
Practice Address - Street 1:1501 WESTPORT RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-4366
Practice Address - Country:US
Practice Address - Phone:816-282-0131
Practice Address - Fax:816-282-0136
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014023980363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily