Provider Demographics
NPI:1578369336
Name:VAN SAMBEEK, SHAY
Entity type:Individual
Prefix:
First Name:SHAY
Middle Name:
Last Name:VAN SAMBEEK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W2597 OAKMEADOW CT
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-8749
Mailing Address - Country:US
Mailing Address - Phone:920-358-3035
Mailing Address - Fax:
Practice Address - Street 1:1750 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-1453
Practice Address - Country:US
Practice Address - Phone:816-654-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program