Basic Information
| Provider Information | |||||||||
| NPI: | 1649642497 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRATTON | ||||||||
| FirstName: | SHELETHA | ||||||||
| MiddleName: | RENEE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 S CLAY ST STE 104 | ||||||||
| Address2: | |||||||||
| City: | ENNIS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751195771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728756600 | ||||||||
| FaxNumber: | 8173913252 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 S CLAY ST STE 104 | ||||||||
| Address2: | |||||||||
| City: | ENNIS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751195771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728756600 | ||||||||
| FaxNumber: | 8173913252 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2015 | ||||||||
| LastUpdateDate: | 02/01/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP129245 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.