Individual provider · Type 1 NPI
Shane Ashley Correa, NP
Family Nurse Practitioner · Tyler, TX
NPI number
1255801189
Active
Practice location
1000 S Beckham Ave
Tyler, TX 75701-1908
Fax (903) 535-6884
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | AP139832 (TX) |
Family Nurse Practitioner: Definition to come...
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About NPI 1255801189
Shane Ashley Correa, NP's National Provider Identifier is 1255801189, issued on Dec 4, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Tyler, TX. The record was last updated on May 15, 2024.