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General NPI Number Information
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NPI Number | 1194577965
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Entity Type | Individual
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Provider Name | SHAQUITA CHANTE ROBINSON AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 6363 STATE HWY 161
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City | IRVING
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State | TX
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Zip | 75038-2269
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Country | US
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Telephone | 254-218-3295
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Fax |
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Provider Business Mailing Address
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Address Line | 308 N CANNADY CIR
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City | CEDAR HILL
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State | TX
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Zip | 75104-6037
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Country | US
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Telephone | 469-258-5453
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1142460
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License Number State | TX
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