Most Relevant Information
Provider Data
| NPI Number: | 1003287848 |
| Provider Name: | LACOSTA KAY GAINES DNP, APRN, FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP2300X |
| Specialty: | Nurse Practitioner |
| License Number: | 2015035184 |
Most Important Dates
| Enumeration Date: | 10/19/2015 |
| Last Updated: | 09/25/2023 |
Provider Practice Location
400 S CENTER ST
SHELBINA
MO
634681404
Practice Location Phone/Fax
| Phone: | 5735884131 |
| Fax: | 5735884876 |
Provider Mailing Location
400 S CENTER ST
SHELBINA
MO
634681404
Provider Mailing Phone/Fax
| Phone: | 5735884131 |
| Fax: | 5735884876 |