MEDICARE: PERIMENOPAUSE PRACTITIONER

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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1336094606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERIMENOPAUSE PRACTITIONER

Provider Business Mailing Address
First Line	:	5900 BALCONES DR STE 24369
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4257
Country	:	US
Telephone Number	:	915-209-0118
Fax Number	:	915-250-0113

Provider Business Practice Location Address
First Line	:	11201 ARMOUR DR STE A2
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79935-4811
Country	:	US
Telephone Number	:	915-209-0118
Fax Number	:	915-250-0113

Authorized Official
Title or Position	:	NURSE PRACTITIONER, OWNER
Name	:	SHAKEEKA ALLISON MISHER
Credential	:	FNP
Telephone Number	:	915-209-0118

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

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Directions to “PERIMENOPAUSE PRACTITIONER ” Practice Location

Language	Start Address	Practice Location

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