Provider Demographics
NPI:1245789346
Name:NAMPIMADOM, SHEENA (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:NAMPIMADOM
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 1:4123 TURTLE TRAILS LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2746
Mailing Address - Country:US
Mailing Address - Phone:281-741-5767
Mailing Address - Fax:
Practice Address - Street 1:9504 LONG POINT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4226
Practice Address - Country:US
Practice Address - Phone:713-461-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily