Provider Demographics
NPI:1023813862
Name:CUMMINS, SHAINA
Entity type:Individual
Prefix:
First Name:SHAINA
Middle Name:
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 WILD INDIGO DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-4688
Mailing Address - Country:US
Mailing Address - Phone:407-803-2447
Mailing Address - Fax:
Practice Address - Street 1:5900 LAKE ELLENOR DR STE 150
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4663
Practice Address - Country:US
Practice Address - Phone:407-393-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1175019363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner