Individual
SHANTELL KOREY HAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2014 BEN MERRITT DR STE A, DECATUR, TX 76234-3851
(940) 249-9009
Mailing address
PO BOX 2078, DECATUR, TX 76234-6156
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP135654
TX
363LF0000X
Family Nurse Practitioner
AP135654
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379841501
—
TX
01
—
8HV879
BCBSTX
TX
Enumeration date
10/31/2017
Last updated
11/10/2023
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