Provider Demographics
NPI:1710575535
Name:SADBERRY, SHANTELL (RN)
Entity Type:Individual
Prefix:
First Name:SHANTELL
Middle Name:
Last Name:SADBERRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 N CENTRAL EXPY UNIT 2751
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-0147
Mailing Address - Country:US
Mailing Address - Phone:817-470-2633
Mailing Address - Fax:
Practice Address - Street 1:15922 EL DORADO PARKWAY #500 #578
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035
Practice Address - Country:US
Practice Address - Phone:817-470-2633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management