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General NPI Number Information
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NPI Number | 1295207694
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Entity Type | Individual
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Provider Name | SHAYNA ROBERTS LPN
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Gender | Female
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Dates
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Enumeration Date | 12/23/2018
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 612 E LAMAR BLVD
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City | ARLINGTON
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State | TX
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Zip | 76011-4121
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Country | US
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Telephone | 877-847-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 6301 STONEWOOD DR APT 1827
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City | PLANO
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State | TX
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Zip | 75024-5275
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Country | US
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Telephone |
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 1016290
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP60452766
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License Number State | WA
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