Provider Demographics
NPI:1689118143
Name:SHAHAN, KAREN (NP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:SHAHAN
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 1:1005 W RALPH HALL PKWY STE 137
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6691
Mailing Address - Country:US
Mailing Address - Phone:972-463-2001
Mailing Address - Fax:972-463-2003
Practice Address - Street 1:1005 W RALPH HALL PKWY STE 137
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6691
Practice Address - Country:US
Practice Address - Phone:972-463-2001
Practice Address - Fax:972-463-2003
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1019068363LF0000X
IL209015330363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily