Provider Demographics
NPI:1316329881
Name:RUNNION, SHAYNE
Entity type:Individual
Prefix:
First Name:SHAYNE
Middle Name:
Last Name:RUNNION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 31 RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NE
Mailing Address - Zip Code:68939-5158
Mailing Address - Country:US
Mailing Address - Phone:620-388-5178
Mailing Address - Fax:308-425-3167
Practice Address - Street 1:205 F ST STE 215
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:KS
Practice Address - Zip Code:67661-1943
Practice Address - Country:US
Practice Address - Phone:620-388-5178
Practice Address - Fax:308-425-3167
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9627104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker