Provider Demographics
NPI:1063742419
Name:GOODE, SHIRLEY ANN (MSN)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:ANN
Last Name:GOODE
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5844 NW BARRY RD
Mailing Address - Street 2:STE 310
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1465
Mailing Address - Country:US
Mailing Address - Phone:816-741-9122
Mailing Address - Fax:816-741-9665
Practice Address - Street 1:5844 NW BARRY RD
Practice Address - Street 2:STE 310
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1465
Practice Address - Country:US
Practice Address - Phone:816-741-9122
Practice Address - Fax:816-741-9665
Is Sole Proprietor?:No
Enumeration Date:2010-01-07
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO057192363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health