Leake, Shannon D
Leake, Shannon D is an sole proprietor health care provider with primary practice located at 410 N Jefferson Ave # 262 , Mount Pleasant TX 75455-3937. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Leake, Shannon D can be contacted via phone (903) 287-5788.Contact Information
Primary practice address
410 N Jefferson Ave # 262
Mount Pleasant TX 75455-3937
Phone: (903) 287-5788
Fax: (903) 213-9031
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP144577 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 63678 | New Mexico |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 0002825-C-NP | Colorado |
Profile Details
| NPI number | 1598304115 |
|---|---|
| LBN Legal business name | Leake, Shannon D |
| Credentials | APRN, FNP-C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 30th, 2019 |
| Last updated | Sep 23rd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598304115 | NPPES |
| New Mexico | Other | 63678 | NEW MEXICO BOARD OF NURSING |
| New Mexico | Other | 0002825-C-NP | NEW MEXICO BOARD OF NURSING |
| New Mexico | Other | AP144577 | NEW MEXICO BOARD OF NURSING |
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