Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP146186 | TX |
NPI | 1083232276 |
---|---|
Provider Name | Kristin Sheneman |
First Address | Dallas, TX 75209-6203 |
Second Address | Frisco, TX 75033-3578 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2020 |
Last Update Date | 14/07/2020 |