Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP129305 | TX |
NPI | 1053783670 |
---|---|
Provider Name | Meagan Sheldon |
First Address | Lubbock, TX 79430-0002 |
Second Address | Houston, TX 77030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2015 |
Last Update Date | 12/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
353365502 | (05) | TX |