MEDICARE: SHANI RASHIDA MAYS MSN, APRN, PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1178456	TX

General Provider Information

NPI Number	:	1922811710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANI RASHIDA MAYS MSN, APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	3104 CAPITAL WAY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-4305
Country	:	US
Telephone Number	:	904-373-7113
Fax Number	:	817-835-7233

Provider Business Practice Location Address
First Line	:	3104 CAPITAL WAY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-4305
Country	:	US
Telephone Number	:	940-373-7113
Fax Number	:	682-286-5665

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

Provider Enumeration Date	:	01/28/2025
Last Update Date	:	04/30/2025

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