Provider Demographics
NPI:1407472897
Name:FEUQUAY, SHIRLINA (BSN, RN, CA-CP SANE)
Entity Type:Individual
Prefix:
First Name:SHIRLINA
Middle Name:
Last Name:FEUQUAY
Suffix:
Gender:F
Credentials:BSN, RN, CA-CP SANE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 WILD HORSE
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75706-4244
Mailing Address - Country:US
Mailing Address - Phone:903-749-0525
Mailing Address - Fax:
Practice Address - Street 1:12201 WILD HORSE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75706-4244
Practice Address - Country:US
Practice Address - Phone:903-749-0525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX729627163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse