MRS. FARAH LYNN SHADDIX


Address: 1103 Warm Winds Dr, O Fallon, MO 63366-6327
Phone: 6362940673

MRS. FARAH LYNN SHADDIX (NPI# 1912524059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912524059
Entity Type Individual
Full Name MRS. FARAH LYNN SHADDIX
Credential MSN, RN, PMHNP-BC
Practice Address 1103 Warm Winds Dr
O Fallon
MO 63366-6327
Practice Telephone 6362940673
Mailing Telephone 6362940673
Enumeration Date 2020-07-05
Last Update Date 2020-07-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
2020019555 MO Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1103 WARM WINDS DR
City O FALLON
State MO
Zip Code 63366-6327

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NPI Name Taxonomy Address Enumeration
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1740754126 Donna Marie Person Nurse Practitioner 331 Magnolia Valley Dr., Ofallon, MO 63366 2019-01-18
1679069470 Samantha Schulte Clinical Pharmacology 7 Poor Richard Ct, O Fallon, MO 63366 2018-07-03
1790218048 Jill Buery Marriage & Family Therapist 801 S Woodlawn Ave, Ste 15, O'fallon, MO 63366 2017-04-04
1114466968 Jessica Anne Morris Counselor 103 Lincoln Street, O'fallon, MO 63366 2017-02-13
1639528540 Kyle James Neuschaefer Dentist 31 Ofallon Sq, O Fallon, MO 63366 2016-06-10
1295116143 Katherine Seiler Harkess Obstetrics & Gynecology 300 Winding Woods Drive Suite 200, O'fallon, MO 63366 2015-06-16
1528453354 Amanda Flamm Nurse Practitioner 1101 Hightway K, Ofallon, MO 63366 2015-03-30
1144639972 Sara Birkemeier Physical Therapist 1541 Norwood Hills Dr, Ofallon, MO 63366 2014-08-06
1710390893 Catherine Rose Most Speech-Language Pathologist 555 E. Terra Lane, Fort Zumwalt School District, O'fallon, MO 63366 2014-06-06
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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1063044626 Beatriz Fortaleza Nurse Practitioner 2305 South 65 Highway, Bldg A., Marshall, MO 65340-3702 2020-02-11
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Competitor

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City O FALLON
Zip Code 63366

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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