Individual provider Active NPI

Shanon Leigh Coulter, RN

  • Plastic Surgery Registered Nurse
  • Lubbock, TX
National Provider Identifier
1205744455
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Registered NurseTaxonomy code 163WS0121X
License
647411 Issued in TX
Practice address
10703 Milwaukee Ave
Lubbock, TX 79424-6153
Phone
(806) 777-1350
NPI assigned
Aug 31, 2026
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Registered Nurse 163WS0121X 647411 TX Primary

Addresses

Primary practice location

10703 Milwaukee Ave
Lubbock, TX 79424-6153

Mailing address

10703 Milwaukee Ave
Lubbock, TX 79424-6153
Phone (806) 777-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1205744455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10703 MILWAUKEE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794246153",
            "telephone_number": "806-777-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10703 MILWAUKEE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794246153",
            "telephone_number": "806-777-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "SHANON",
        "middle_name": "LEIGH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0121X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Plastic Surgery",
            "state": "TX",
            "license": "647411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.