Healthcare Provider Details

I. General information

NPI: 1649642497
Provider Name (Legal Business Name): SHELETHA RENEE BRATTON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W FERGUSON RD STE 3000
MT PLEASANT TX
75455-2973
US

IV. Provider business mailing address

601 S CLAY ST STE 104
ENNIS TX
75119-5771
US

V. Phone/Fax

Practice location:
  • Phone: 903-352-3424
  • Fax: 855-570-8200
Mailing address:
  • Phone: 972-875-6600
  • Fax: 817-391-3252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP129245
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: