Provider Demographics
NPI:1194577965
Name:ROBINSON, SHAQUITA CHANTE (AGPCNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHAQUITA
Middle Name:CHANTE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:MS
Other - First Name:SHAQUITA
Other - Middle Name:CHANTE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:308 N CANNADY CIR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-6037
Mailing Address - Country:US
Mailing Address - Phone:469-258-5453
Mailing Address - Fax:
Practice Address - Street 1:6363 STATE HWY 161
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-2269
Practice Address - Country:US
Practice Address - Phone:254-218-3295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1142460363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology