Provider Demographics
NPI:1659788891
Name:SHIELD, DEBRA ELAINE (FNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ELAINE
Last Name:SHIELD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 HOSPITAL CIR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-4771
Mailing Address - Country:US
Mailing Address - Phone:979-241-6190
Mailing Address - Fax:
Practice Address - Street 1:600 HOSPITAL CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-4771
Practice Address - Country:US
Practice Address - Phone:979-241-6190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily