SHANNON LARIE MITCHELL (NPI# 1669665964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669665964 |
| Entity Type | Individual |
| Full Name | SHANNON LARIE MITCHELL |
| Other Name | SHANNON LARIE HUMPHREY |
| Credential | RN-ACNP |
| Practice Address |
5002 Cowhorn Creek Rd Texarkana TX 75503-9766 |
| Practice Telephone | 9036143000 |
| Practice Fax Number | 9036143525 |
| Mailing Telephone | 9036143000 |
| Mailing Fax Number | 9036143525 |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2015-08-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
AP115188 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
653277 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | APRN | AP115188 | 01 |
| TX | RN | 653277 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104475144 | Shannon Mitchell | Behavior Technician | 400 Galloway St Ne Apt 347s, Washington, DC 20011-6399 | 2019-09-11 |
| 1376037374 | Shannon M Mitchell | Clinic/Center | 3900 Max Place, Unit 101, Boynton Beach, FL 33436 | 2018-06-22 |
| 1568814903 | Shannon Mitchell | Specialist/Technologist | 234 Crestwood Dr, Clifton Heights, PA 19018-1203 | 2016-07-11 |
| 1144551797 | Shannon Hawkley Mitchell | Optometrist | 5274 Main St Ste 1, Waitsfield, VT 05673-4445 | 2010-01-21 |
| 1003034901 | Shannon J Mitchell | Behavioral Analyst | 10 Chartres Ct, Lake St Louis, MO 63367-1230 | 2007-04-23 |
| 1881727444 | Shannon L Mitchell | Counselor | 10763 W Clover Way, Avondale, AZ 85323-4010 | 2007-03-13 |
| 1972631653 | Shannon Mitchell | Dental Hygienist | 2300 Lancaster Drive Ne, Salem, OR 97305 | 2007-03-02 |
| 1467934281 | Shannon Mitchell | Case Manager/Care Coordinator | 825 Center St Ste A, New Iberia, LA 70560-5500 | 2018-08-29 |
| 1821581273 | Shannon Nicole Mitchell | Registered Nurse | 2151 Rush Blvd, Youngstown, OH 44507-1535 | 2018-06-11 |
| 1538675574 | Shannon Eileen Mitchell | Social Worker | 2814 S Grand Blvd, Spokane, WA 99203-2528 | 2017-12-27 |
| Street Address |
5002 COWHORN CREEK RD |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-9766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447255229 | Jeffrey David Decaprio | Surgery | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-06-17 |
| 1225681604 | Lauren N. Hadaway | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2019-07-24 |
| 1144872839 | Brandi M. Martin | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2019-07-12 |
| 1093292104 | Heidi R Smith | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-07-20 |
| 1194215814 | Angela L Bowen | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-05-17 |
| 1689174955 | Cody C Ray | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-02-13 |
| 1699282087 | Melissa Ann Lamon | Registered Nurse | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2018-01-07 |
| 1013443589 | Laura L Jackson | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-05-03 |
| 1316478852 | Schamma Salomon | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-03-26 |
| 1346781325 | Melissa Elizabeth Redfearn | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538609920 | Jamie Patterson | Nurse Practitioner | 6018 Summerwood Ln, Texarkana, AR 71854-9403 | 2017-03-03 |
| 1194090787 | Candace Ann Hambleton | Nurse Practitioner | 5602 Richmond Rd Ste 104, Texarkana, TX 75503-0877 | 2012-03-14 |
| 1891955043 | Charles Shoalmire Jr. | Nurse Practitioner | 2604 Saint Michael Dr Ste 345, Texarkana, TX 75503-2378 | 2008-06-11 |
| 1518147776 | Amy A Kennemore | Nurse Practitioner | 1002 Texas Blvd Ste 325, Texarkana, TX 75501-5118 | 2007-11-05 |
| 1417416819 | Erin Mccasland | Nurse Practitioner | 5730 Summerhill Rd, Texarkana, TX 75503-1635 | 2019-03-15 |
| 1467939975 | John Benjamin Harrison | Nurse Practitioner | 2600 Saint Michael Dr, Texarkana, TX 75503-5220 | 2018-07-26 |
| 1629420310 | Tanya Lynn Austin | Nurse Practitioner | 2600 Saint Michael Dr, Texarkana, TX 75503-5220 | 2016-07-06 |
| 1730583840 | Jacob Kelton | Nurse Practitioner | 2600 Saint Michael Dr, Texarkana, TX 75503-5220 | 2014-10-17 |
| 1144623356 | Michael Thomas Crabtree | Nurse Practitioner | 4105 N Kings Hwy, Texarkana, TX 75503-4861 | 2014-10-01 |
| 1699066969 | Mandy Michelle Carter | Nurse Practitioner | 921 Texas Blvd Ste D, Texarkana, TX 75501-5163 | 2011-04-21 |
| Find all providers in TEXARKANA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.