Shanda Lynne Petty, MSN, APRN, FNP-C
Nurse Practitioner, Family in Sunset, TX. Individual provider (NPI-1).
NPI number1013668037
StatusActive
Last updated in NPPESSep 15, 2022
Details
- NPI
- 1013668037
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Shanda Lynne Petty
- Credential
- MSN, APRN, FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 11, 2022
- Certification date
- Sep 15, 2022
- Last updated
- Sep 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F08220790 | TX | Yes |
Practice location
2046 County Road 1790Sunset, TX 76270-5331
Phone 940-255-6009
Mailing address
2046 County Road 1790Sunset, TX 76270-5331
Phone 940-255-6009
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