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Individual
NANCY A SHAKIN
Active
Individual
NANCY A SHAKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02167
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181346101
—
TX
05
—
181346102
—
TX
01
—
1992735674
BLUE CROSS BLUE SHIELD
TX
01
—
8N8785
BCBS
TX
Enumeration date
07/05/2006
Last updated
09/22/2011
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