Provider Demographics
NPI:1265260335
Name:CEGLINSKY, SHANNON DONNELL (FNP)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:DONNELL
Last Name:CEGLINSKY
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 1:2905 SOLITUDE CANYON DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3315
Mailing Address - Country:US
Mailing Address - Phone:805-587-5174
Mailing Address - Fax:
Practice Address - Street 1:2381 E UNIVERSITY DR STE 50
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2390
Practice Address - Country:US
Practice Address - Phone:972-987-0458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1169541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily