Provider Demographics
NPI:1518780600
Name:HIBBLER, SHALISA LASHUNDRA (APRN, AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:SHALISA
Middle Name:LASHUNDRA
Last Name:HIBBLER
Suffix:
Gender:F
Credentials:APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LEONA HTS
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-4715
Mailing Address - Country:US
Mailing Address - Phone:662-588-3460
Mailing Address - Fax:
Practice Address - Street 1:12 LEONA HTS
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-4715
Practice Address - Country:US
Practice Address - Phone:662-588-3460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care