Most Relevant Information
Provider Data
| NPI Number: | 1003382078 |
| Provider Name: | MALORY SHANKS FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | AP139274 |
Most Important Dates
| Enumeration Date: | 10/17/2018 |
| Last Updated: | 09/01/2020 |
Provider Practice Location
6104 AVENUE Q SOUTH DR
LUBBOCK
TX
794123700
Practice Location Phone/Fax
| Phone: | 8064723400 |
| Fax: |
Provider Mailing Location
6104 AVENUE Q SOUTH DRIVE
LUBBOCK
TX
79412
Provider Mailing Phone/Fax
| Phone: | 8064723400 |
| Fax: |