Provider Demographics
NPI:1821811605
Name:SHINN, SIERRA DAWN (MPAS, PA-C)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:DAWN
Last Name:SHINN
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:451 KINGWOOD MEDICAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6408
Mailing Address - Country:US
Mailing Address - Phone:281-359-2080
Mailing Address - Fax:281-359-2421
Practice Address - Street 1:451 KINGWOOD MEDICAL DR STE 200
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6408
Practice Address - Country:US
Practice Address - Phone:281-359-2080
Practice Address - Fax:281-359-2421
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
TXPA18523363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant