Provider Demographics
NPI:1487412565
Name:BUCKLEY, SHAWNA MARIE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:MARIE
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:BUCKLEY
Other - Last Name:GLOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3051 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2023
Mailing Address - Country:US
Mailing Address - Phone:817-468-1818
Mailing Address - Fax:
Practice Address - Street 1:3051 S CENTER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2023
Practice Address - Country:US
Practice Address - Phone:817-468-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140232363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily