Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shawntay Sparks, ACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1144899741

Shawntay Sparks, ACNP-BC is a Nurse Practitioner in Mineral Wells, Texas. Qualified in 2021, 5 years ago. Practices with Providence Health Alliance, a 122-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Texas.

Years since qualifying
5
Licensed in
TX
In the registry since
2021

Practice location Address checks out

400 SW 25th Ave
Mineral Wells, TX 76067-8246
Phone: (325) 647-6979
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 1044883 (TX)

Record details

NPI number1144899741
Entity typeIndividual (Type 1)
GenderFemale
Credentials ACNP-BC
Sole proprietorYes
NPI enumeratedJune 18, 2021
Last updated in NPPESJune 18, 2021
Certification dateJune 18, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Providence Health Alliance — 122 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare