Provider Demographics
NPI:1750116216
Name:BERRIER, SHANNAN RENEA (FNP)
Entity type:Individual
Prefix:MRS
First Name:SHANNAN
Middle Name:RENEA
Last Name:BERRIER
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 1:4200 S LAKE FOREST DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7346
Mailing Address - Country:US
Mailing Address - Phone:214-592-0356
Mailing Address - Fax:
Practice Address - Street 1:4200 S LAKE FOREST DR STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7346
Practice Address - Country:US
Practice Address - Phone:214-592-0356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152769363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily