Provider Demographics
NPI:1962246199
Name:SHUMPERT, SHEENA MARSHA (RN)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:MARSHA
Last Name:SHUMPERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SHEENA
Other - Middle Name:MARSHA
Other - Last Name:COWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1050 GALATYN PKWY APT 3196
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4451
Mailing Address - Country:US
Mailing Address - Phone:662-913-9810
Mailing Address - Fax:
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:972-566-7301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152704163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse