Provider Demographics
NPI:1215304894
Name:ADAMS, SHAUNDA LEIGH (ABOC)
Entity type:Individual
Prefix:MRS
First Name:SHAUNDA
Middle Name:LEIGH
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ABOC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1416 W SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-4133
Mailing Address - Country:US
Mailing Address - Phone:913-712-6677
Mailing Address - Fax:913-780-3087
Practice Address - Street 1:1416 W SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-4133
Practice Address - Country:US
Practice Address - Phone:913-712-6677
Practice Address - Fax:913-780-3087
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-30
Last Update Date:2015-08-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician