1649642497 NPI number — MRS. SHELETHA RENEE BRATTON FNP

Table of content: MRS. SHELETHA RENEE BRATTON FNP (NPI 1649642497)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649642497 NPI number — MRS. SHELETHA RENEE BRATTON FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRATTON
Provider First Name:
SHELETHA
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649642497
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/18/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 S CLAY ST STE 104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENNIS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75119-5771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-875-6600
Provider Business Mailing Address Fax Number:
817-391-3252

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 W FERGUSON RD STE 3000
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT PLEASANT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75455-2973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-352-3424
Provider Business Practice Location Address Fax Number:
855-570-8200
Provider Enumeration Date:
10/20/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP129245 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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