Provider Demographics
NPI:1124388608
Name:WESTFALL, SHELLY (LE)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:
Last Name:WESTFALL
Suffix:
Gender:F
Credentials:LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10777 NALL AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1362
Mailing Address - Country:US
Mailing Address - Phone:913-588-7600
Mailing Address - Fax:913-588-9264
Practice Address - Street 1:10777 NALL AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1362
Practice Address - Country:US
Practice Address - Phone:913-588-7600
Practice Address - Fax:913-588-9264
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS26775174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist