Shakaiela Byrd
Nurse Practitioner, Family in Desoto, TX. Individual provider (NPI-1).
NPI number1225711617
StatusActive
Last updated in NPPESJan 20, 2025
Details
- NPI
- 1225711617
- Entity type
- Individual (NPI-1)
- Name
- Shakaiela Byrd
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 10, 2023
- Certification date
- Jan 20, 2025
- Last updated
- Jan 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 1114196 | TX | Yes |
| 163W00000X | Registered Nurse | 990518 | TX |
Practice location
2727 Bolton Boone Dr Ste 101Desoto, TX 75115-2019
Phone 817-583-7040
Mailing address
1115 Wayne AveDuncanville, TX 75137-4745
Phone 865-556-2818
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