Provider Demographics
NPI:1902693310
Name:SHIELDS, SANDRA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:SHIELDS
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 PINNACLE DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-5433
Mailing Address - Country:US
Mailing Address - Phone:915-491-0868
Mailing Address - Fax:
Practice Address - Street 1:2001 INWOOD RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7202
Practice Address - Country:US
Practice Address - Phone:214-645-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1195562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily