Provider Demographics
NPI:1811505019
Name:GUY, SHANNA RENE' (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:SHANNA
Middle Name:RENE'
Last Name:GUY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 RIDGEWOOD DR APT 25
Mailing Address - Street 2:
Mailing Address - City:PORT NECHES
Mailing Address - State:TX
Mailing Address - Zip Code:77651-5915
Mailing Address - Country:US
Mailing Address - Phone:409-455-0247
Mailing Address - Fax:
Practice Address - Street 1:14141 SOUTHWEST FWY STE 500
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3494
Practice Address - Country:US
Practice Address - Phone:281-356-0364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1003024363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily