Individual
SHAWNTAY SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
400 SW 25TH AVE, MINERAL WELLS, TX 76067-8246
(325) 647-6979
Mailing address
1 CREEKWOOD CIR, BROWNWOOD, TX 76801-6651
(325) 647-6979
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1044883
TX
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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