Provider Demographics
NPI:1114287422
Name:CHAN, SHEYANNE (DNP, CPNP)
Entity Type:Individual
Prefix:
First Name:SHEYANNE
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:DNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0351
Mailing Address - Country:US
Mailing Address - Phone:409-772-3695
Mailing Address - Fax:832-340-2350
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0351
Practice Address - Country:US
Practice Address - Phone:409-772-3695
Practice Address - Fax:832-340-2350
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX717639163WP0200X
TXAP116809363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics