Provider Demographics
NPI:1487041760
Name:PARSON, SHONQUATTA (NNP)
Entity Type:Individual
Prefix:
First Name:SHONQUATTA
Middle Name:
Last Name:PARSON
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5995 SUMMERSIDE DR
Mailing Address - Street 2:#797091
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-0002
Mailing Address - Country:US
Mailing Address - Phone:615-955-0054
Mailing Address - Fax:
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-2997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127904363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal