Provider Demographics
NPI:1396903373
Name:COVEY, SHAYNA TERESE (CPM, LM)
Entity type:Individual
Prefix:MISS
First Name:SHAYNA
Middle Name:TERESE
Last Name:COVEY
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 LANTANA RD
Mailing Address - Street 2:
Mailing Address - City:GILMER
Mailing Address - State:TX
Mailing Address - Zip Code:75644-5853
Mailing Address - Country:US
Mailing Address - Phone:903-797-4362
Mailing Address - Fax:
Practice Address - Street 1:304 LANTANA RD
Practice Address - Street 2:
Practice Address - City:GILMER
Practice Address - State:TX
Practice Address - Zip Code:75644-5853
Practice Address - Country:US
Practice Address - Phone:903-797-4362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99058176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife