Provider Demographics
NPI:1932764529
Name:SAPAUGH, SHAWNA LYNN (NP-C)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:LYNN
Last Name:SAPAUGH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:LYNN
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:417 ERDMANN RD
Mailing Address - Street 2:
Mailing Address - City:CAMDENTON
Mailing Address - State:MO
Mailing Address - Zip Code:65020-4517
Mailing Address - Country:US
Mailing Address - Phone:417-372-0350
Mailing Address - Fax:
Practice Address - Street 1:1712 S LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-7542
Practice Address - Country:US
Practice Address - Phone:660-827-2526
Practice Address - Fax:660-827-5536
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019008658363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner