Michael Shannon Ervin
Individual provider Active NPI Registered Nurse · Early, TX
NPI 1972077766 · NPPES record last updated Jan 15, 2019
Key facts
- NPI
- 1972077766
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 940378 (TX)
- Practice address
- 241 Briarcrest
Early, TX 76802-3445 - Phone
- (817) 320-6790
- NPI assigned
- Jan 15, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 940378 | TX | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 940378 | TX | Yes |
Addresses
Primary practice location
241 Briarcrest
Early, TX 76802-3445
Mailing address
241 Briarcrest
Early, TX 76802-3445
Phone (817) 320-6790
Other providers in Early, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.