Provider Demographics
NPI:1306460639
Name:WRIGHT-DOWNS, SHAVONN LYNETTE
Entity type:Individual
Prefix:
First Name:SHAVONN
Middle Name:LYNETTE
Last Name:WRIGHT-DOWNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 FOREST HOLLOW LN APT 2324
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-3013
Mailing Address - Country:US
Mailing Address - Phone:214-418-1733
Mailing Address - Fax:
Practice Address - Street 1:4099 MCEWEN RD
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-5030
Practice Address - Country:US
Practice Address - Phone:972-523-2749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313285164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20077992OtherDRIVER LICENSE
TX313285OtherTEXAS BOARD OF NURSING