Provider Demographics
NPI:1003052846
Name:SHEARER, NICHOLE DEVERAUX (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:DEVERAUX
Last Name:SHEARER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 CLARA BARTON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-5738
Mailing Address - Country:US
Mailing Address - Phone:972-272-6561
Mailing Address - Fax:
Practice Address - Street 1:601 CLARA BARTON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5738
Practice Address - Country:US
Practice Address - Phone:972-272-6561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX721152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L20626Medicare PIN