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NPI Code Detail

MEDICARE: MARISSA M SHUFFIELD PA

MEDICARE: MARISSA M SHUFFIELD PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA06234TX

General Provider Information

NPI Number : 1013146257
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA M SHUFFIELD PA
Provider Business Mailing Address
First Line : 2005 FORT WORTH HWY
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-4779
Country : US
Telephone Number : 817-598-5620
Fax Number : 817-598-5621
Provider Business Practice Location Address
First Line : 2005 FORT WORTH HWY
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-4779
Country : US
Telephone Number : 817-598-5620
Fax Number : 817-598-5621
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2009
Last Update Date : 01/09/2020

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Directions to “ MARISSA M SHUFFIELD PA” Practice Location

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