| Doctor Name: | SHAWNEE LYNN KELLISON |
| NPI Number: | 1063495463 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RNBCFNP |
| License Number: | 113721 |
| Business Practice Address: | 700 W Jefferson St Kirksville, MO - 635011441 |
| Business Phone Number: | 6606262191 |
| Business Fax Number: | 6606262396 |
| Mailing Address: | 700 W Jefferson St, Po Box 7545 KIRKSVILLE |
| State: | MO |
| Postal Code: | 635011441 |
| Phone Number: | 6606262191 |
| Fax Number: | 6606262396 |
| NPI Enumeration Date: | 11/21/2005 |
| NPI Last Update Date: | 01/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 113721 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |