| NPI | 1669360079 |
|---|---|
| Former Name | SHAVONNE RENEE FAUST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1143304) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: TX 1143304) |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-09-25 |