Provider Demographics
NPI:1497411888
Name:COLWILL, SHEENA GILL (NP)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:GILL
Last Name:COLWILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6605 WARWICK DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-8762
Mailing Address - Country:US
Mailing Address - Phone:469-371-3116
Mailing Address - Fax:
Practice Address - Street 1:9820 N CENTRAL EXPY STE 514
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4311
Practice Address - Country:US
Practice Address - Phone:469-214-7649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP146008363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner