Provider Demographics
NPI:1427457639
Name:SCOTT, SHANNON LYNN (NP-C)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:LYNN
Last Name:SCOTT
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 GOODELL CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-6404
Mailing Address - Country:US
Mailing Address - Phone:785-424-8086
Mailing Address - Fax:
Practice Address - Street 1:6860 W 115TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-2457
Practice Address - Country:US
Practice Address - Phone:785-424-8086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-129803-031163W00000X
TN0000111526163W00000X
MO2015021973163WP0200X
MO2015021974363LP2300X
KS53-76640-031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care