Provider Demographics
NPI:1922569896
Name:TOOLE, SHANNON DANIELLE (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:DANIELLE
Last Name:TOOLE
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:515 MAPLE VALLEY DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1919
Practice Address - Country:US
Practice Address - Phone:573-760-7920
Practice Address - Fax:573-756-9597
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2018037561363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily