| Mary Ellen Shanks, APRN,BC,FNP | |
| 
					504 N Sturgeon St, Montgomery City, MO 63361-1829  | |
| (573) 564-2990 | |
| (573) 564-2963 | 
| Full Name | Mary Ellen Shanks | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 504 N Sturgeon St, Montgomery City, Missouri | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1710293972 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 2010027851 (Missouri) | Primary | 
| Entity Name | Hermann Area Hospital District | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1083749188 PECOS PAC ID: 5496669962 Enrollment ID: O20031118000740  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mary Ellen Shanks, APRN,BC,FNP Po Box 19, Montgomery City, MO 63361-0019 Ph: (573) 564-2990  | Mary Ellen Shanks, APRN,BC,FNP 504 N Sturgeon St, Montgomery City, MO 63361-1829 Ph: (573) 564-2990  | 
Kristina Boylan, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 240 Pickering St, Montgomery City, MO 63361 Phone: 573-564-2101 Fax: 573-564-2130  | |
Holly Thomas, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1225 Aguilar Dr, Montgomery City, MO 63361 Phone: 573-582-1234 Fax: 573-582-1212  | |
Londa Y Swoboda, FNP, BSN, MSN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 111 E 1st St, Montgomery City, MO 63361 Phone: 573-564-3214 Fax: 573-564-3216  | |
Mrs. Diana L Gibbs, RNC  WHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 400 Salisbury St, Montgomery City, MO 63361 Phone: 573-564-2495 Fax: 573-564-5059  |