Provider Demographics
NPI:1902146137
Name:MCSHAN, TRAKENYA R (CNA)
Entity Type:Individual
Prefix:MS
First Name:TRAKENYA
Middle Name:R
Last Name:MCSHAN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 W AIRPORT BLVD
Mailing Address - Street 2:3124
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-6670
Mailing Address - Country:US
Mailing Address - Phone:832-762-7549
Mailing Address - Fax:
Practice Address - Street 1:16723 SNOWFLAKE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77053-5029
Practice Address - Country:US
Practice Address - Phone:832-732-7549
Practice Address - Fax:888-221-8310
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
TXNA087170593747A0650X
TXNA87170593747P1801X, 374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide