Provider Demographics
NPI:1417640665
Name:YUDIZKY, SHAYNA CHRISTINE (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SHAYNA
Middle Name:CHRISTINE
Last Name:YUDIZKY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:SHAYNA
Other - Middle Name:CHRISTINE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9301 LAKEVIEW PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4458
Mailing Address - Country:US
Mailing Address - Phone:817-247-2645
Mailing Address - Fax:
Practice Address - Street 1:9301 LAKEVIEW PKWY STE 200
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4458
Practice Address - Country:US
Practice Address - Phone:817-247-2645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1127918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily