Healthcare Provider Details

I. General information

NPI: 1396903373
Provider Name (Legal Business Name): SHAYNA TERESE COVEY C.P.M., L.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 LANTANA RD
GILMER TX
75644-5853
US

IV. Provider business mailing address

304 LANTANA RD
GILMER TX
75644-5853
US

V. Phone/Fax

Practice location:
  • Phone: 903-797-4362
  • Fax:
Mailing address:
  • Phone: 903-797-4362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number99058
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: