MEDICARE: MS. SHAMELL DANAE SPIVEY RN

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
1	163W00000X	Registered Nurse	884191	TX

General Provider Information

NPI Number	:	1083561773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHAMELL DANAE SPIVEY RN

Provider Business Mailing Address
First Line	:	4171 SURREYDON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-2148
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4171 SURREYDON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-2148
Country	:	US
Telephone Number	:	713-340-7975
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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