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NPI Code Detail

MEDICARE: SHAYNA ROBERTS LPN

MEDICARE: SHAYNA ROBERTS LPN
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
1164X00000XLicensed Vocational Nurse1016290TX
2164W00000XLicensed Practical NurseLP60452766WA

General Provider Information

NPI Number : 1295207694
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAYNA ROBERTS LPN
Provider Business Mailing Address
First Line : 6301 STONEWOOD DR APT 1827
Second Line :
City : PLANO
State : TX
Zip : 75024-5275
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 612 E LAMAR BLVD
Second Line :
City : ARLINGTON
State : TX
Zip : 76011-4121
Country : US
Telephone Number : 877-847-9355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2018
Last Update Date : 10/03/2024

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