Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane Austin Stanford, ACAGNP

Individual provider Acute Care Nurse Practitioner · NPI 1871452680

Shane Austin Stanford, ACAGNP is a Nurse Practitioner in Hannibal, Missouri. Qualified in 2025, 1 year ago. Practices with Hannibal Regional Healthcare System Inc, a 259-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
1
Licensed in
MO
In the registry since
2026

Practice location Address checks out

6000 Hospital Dr
Hannibal, MO 63401-6887
Phone: (573) 248-5211
Fax: (573) 248-5210
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 2026001767 (MO)

Record details

NPI number1871452680
Entity typeIndividual (Type 1)
GenderMale
Credentials ACAGNP
Sole proprietorNo
NPI enumeratedJanuary 17, 2026
Last updated in NPPESMarch 12, 2026
Certification dateMarch 12, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Hannibal Regional Healthcare System Inc — 259 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Hannibal