Provider Demographics
NPI:1639506660
Name:NEELY, SHAINA LYNNEE' (FNP-BC, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SHAINA
Middle Name:LYNNEE'
Last Name:NEELY
Suffix:
Gender:F
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 S GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1979
Mailing Address - Country:US
Mailing Address - Phone:806-350-7601
Mailing Address - Fax:806-350-7602
Practice Address - Street 1:2701 S GEORGIA ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1979
Practice Address - Country:US
Practice Address - Phone:806-350-7601
Practice Address - Fax:806-350-7602
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124463364SP0808X
TX757108363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health