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NPI Code Detail

MEDICARE: SHUPTRINE FAMILY PRACTICE

MEDICARE: SHUPTRINE FAMILY PRACTICE
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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1962969584
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHUPTRINE FAMILY PRACTICE
Provider Business Mailing Address
First Line : 14280 STATE HIGHWAY 155
Second Line :
City : FRANKSTON
State : TX
Zip : 75763-6734
Country : US
Telephone Number : 903-574-2612
Fax Number :
Provider Business Practice Location Address
First Line : 107 STACY DR
Second Line :
City : WHITEHOUSE
State : TX
Zip : 75791-3740
Country : US
Telephone Number : 903-839-5050
Fax Number :
Authorized Official
Title or Position : FAMILY NURSE PRACTITIONER
Name : MRS. AMY JO SHUPTRINE
Credential : FNP-BC
Telephone Number : 903-574-2612
Provider Enumeration Date : 03/01/2019
Last Update Date : 05/01/2019

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Directions to “SHUPTRINE FAMILY PRACTICE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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