Provider Demographics
NPI:1265969380
Name:BRATTON, SHENISE NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:SHENISE
Middle Name:NICOLE
Last Name:BRATTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14500 DALLAS PKWY APT 183
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-8312
Mailing Address - Country:US
Mailing Address - Phone:314-814-6320
Mailing Address - Fax:
Practice Address - Street 1:4938 S STAPLES ST STE E8
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-3836
Practice Address - Country:US
Practice Address - Phone:361-452-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-19
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA239660363LF0000X
TXAP134008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily