Provider Demographics
NPI:1215561642
Name:GASAWAY, SHAWN (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:
Last Name:GASAWAY
Suffix:
Gender:M
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 1:5219 CITY BANK PKWY STE 35
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3545
Mailing Address - Country:US
Mailing Address - Phone:806-761-0333
Mailing Address - Fax:806-785-7685
Practice Address - Street 1:7501 QUAKER AVE FL 1
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-3367
Practice Address - Country:US
Practice Address - Phone:806-788-3306
Practice Address - Fax:806-772-3861
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR123641363LF0000X
TX1050304363LF0000X
FL11017089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily