Individual
SHANNON R DOUGREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1401 W PULASKI ST, FORT WORTH, TX 76104-2717
(682) 885-8012
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-4446
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
AP116321
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
AP116321
TX
Other
Enumeration date
10/22/2007
Last updated
10/05/2022
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