Provider Demographics
NPI:1295269132
Name:SHINGE, EMAWAYESH W (APRN)
Entity type:Individual
Prefix:
First Name:EMAWAYESH
Middle Name:W
Last Name:SHINGE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:EMAWAYESH
Other - Middle Name:W
Other - Last Name:SHINGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:1413 OATES DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-1345
Mailing Address - Country:US
Mailing Address - Phone:972-613-7001
Mailing Address - Fax:
Practice Address - Street 1:1413 OATES DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-1345
Practice Address - Country:US
Practice Address - Phone:972-613-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133675363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily