SHAKISHA CROCKETT (NPI# 1740834993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740834993 |
| Entity Type | Individual |
| Full Name | SHAKISHA CROCKETT |
| Credential | MSN,FNP-C |
| Practice Address |
416 Frankford Ave Lubbock TX 79416-4162 |
| Mailing Address |
5219 City Bank Pkwy Ste 35 Lubbock TX 79407-3545 |
| Practice Telephone | 8067610536 |
| Practice Fax Number | 8067610537 |
| Mailing Telephone | 8067610333 |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2020-05-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP141546 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1307 Martin Luther King Blvd, Lubbock, TX 794035329 | 8067493800 |
| Street Address |
416 FRANKFORD AVE |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79416-4162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346247301 | Marcelina Rupley | Pediatrics | 416 Frankford Ave, Lubbock, TX 79416-4162 | 2005-07-06 |
| 1386108033 | Sara Victoria Chapa | Nurse Practitioner | 416 Frankford Ave, Lubbock, TX 79416-4162 | 2019-01-28 |
| 1962466128 | Merry Beth Hart | Pediatrics | 416 Frankford Ave, Lubbock, TX 79416-4162 | 2006-04-14 |
| 1538166491 | James Stanley Garrett | Family Medicine | 416 Frankford Ave, Lubbock, TX 79416-4162 | 2005-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710502174 | Jordan Lane Thompson | Pharmacist | 6313 4th Street, Lubbock, TX 79416 | 2020-06-11 |
| 1821636481 | Chieh-an Chou | Specialist/Technologist | 201 N Winston Ave, Lubbock, TX 79416 | 2019-12-13 |
| 1790341949 | Michael Mcpherson, M.d. P.a. | Internal Medicine | 5406 Colgate St, Lubbock, TX 79416 | 2019-05-14 |
| 1154893675 | South Plains Rehabilitation Hospital, LLC | Rehabilitation Hospital | 5406 Colgate Street, Lubbock, TX 79416 | 2018-12-21 |
| 1932697182 | Timothy Sampana | Student in an Organized Health Care Education/Training Program | 5217 Lehigh St, Lubbock, TX 79416 | 2018-04-24 |
| 1306347711 | 4th Street Dental, Pllc | Dentist | 5709 4th St, Lubbock, TX 79416 | 2018-02-22 |
| 1639682503 | South Plains Surgery Center LLC | Clinic/Center | 4412 6th Street, Lubbock, TX 79416 | 2017-11-14 |
| 1013459809 | Isabel Garcia | Occupational Therapy Assistant | 1717 Northfolk Ave, #a, Lubbock, TX 79416 | 2016-11-09 |
| 1033589213 | Rehab Care | Skilled Nursing Facility | 1717 Norfork Ave, Bldg A, Lubbock, TX 79416 | 2015-10-01 |
| 1902281306 | Carrillon | Clinic/Center | 1717 Norfold Bld A, Lubbock, TX 79416 | 2015-07-27 |
| Find all providers in zip 79416 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911859 | Amber Marie Bowman | Nurse Practitioner | 5106 59th St, Lubbock, TX 79414-4312 | 2020-10-29 |
| 1609475219 | Jonathan-michael Aaron Sisson | Nurse Practitioner | 7421 104th St, Lubbock, TX 79424-6079 | 2020-10-23 |
| 1174134753 | Rebecca Stephanie Castillo | Nurse Practitioner | 5528 109th St, Lubbock, TX 79424-7680 | 2020-08-16 |
| 1508487398 | Mark Angelo Padolina | Nurse Practitioner | 1101 Oshkosh Ave, Lubbock, TX 79416-3810 | 2020-05-03 |
| 1841826724 | Leticia Luna Flores Cooper | Nurse Practitioner | 2511 60th St, Lubbock, TX 79413-5641 | 2020-03-23 |
| 1952931693 | Camella Dawn Ladd | Nurse Practitioner | 1307 Martin Luther King Blvd, Lubbock, TX 79403-5329 | 2020-01-22 |
| 1962042598 | Wendy Geraldine Avalos | Nurse Practitioner | 9304 Primrose Ave, Lubbock, TX 79424-6799 | 2020-01-11 |
| 1619516325 | Jessica Krueger | Nurse Practitioner | 5502 103rd St, Lubbock, TX 79424-6417 | 2019-12-27 |
| 1417596438 | Alicia Michelle Powell | Nurse Practitioner | 6102 82nd St Ste 14, Lubbock, TX 79424-0840 | 2019-12-23 |
| 1376181537 | Ashley Nicole White | Nurse Practitioner | 5614 100th St, Lubbock, TX 79424-6268 | 2019-12-18 |
| Find all providers in LUBBOCK | ||||
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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.