MR. SHAWN R AGENBROAD-ELANDER (NPI# 1164655171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164655171 |
Entity Type | Individual |
Full Name | MR. SHAWN R AGENBROAD-ELANDER |
Credential | FNP-C |
Practice Address |
4303 Victory Dr Austin TX 78704-7507 |
Practice Telephone | 5124623627 |
Practice Fax Number | 5124622898 |
Mailing Telephone | 5124623627 |
Mailing Fax Number | 5124622898 |
Enumeration Date | 2009-08-25 |
Last Update Date | 2018-01-10 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP118041 | TX | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | LICENSE | AP118041 | 01 |
Street Address |
4303 VICTORY DR |
City | AUSTIN |
State | TX |
Zip Code | 78704-7507 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760479059 | Nathan Henry Pekar | Family Medicine | 4303 Victory Dr, Austin, TX 78704-7507 | 2005-10-01 |
1255841706 | Emily Cuyler | Nurse Practitioner | 4303 Victory Dr, Austin, TX 78704-7507 | 2017-10-10 |
1205362555 | Shelley Hardin Salinas | Physical Therapist | 4303 Victory Dr, Austin, TX 78704-7507 | 2017-05-05 |
1396102604 | Value Oriented Medical Clinic Pllc | Family Medicine | 4303 Victory Dr, Austin, TX 78704-7507 | 2016-01-19 |
1497197651 | Katharine Hope Jones | Nurse Practitioner | 4303 Victory Dr, Austin, TX 78704-7507 | 2013-07-29 |
1720332760 | Margaret Suzanne Stephens | Counselor | 4303 Victory Dr, Austin, TX 78704-7507 | 2012-10-30 |
1659639797 | Alisande Davis | Physician Assistant | 4303 Victory Dr, Austin, TX 78704-7507 | 2012-04-26 |
1447585385 | Elizabeth Vasquez | Nurse Practitioner | 4303 Victory Dr, Austin, TX 78704-7507 | 2009-10-09 |
1730311465 | Toth Enterprises II | Pharmacy | 4303 Victory Dr, Austin, TX 78704-7507 | 2009-08-13 |
1609007418 | Charity Ann Green | Nurse Practitioner | 4303 Victory Dr, Suite 201, Austin, TX 78704-7507 | 2009-07-29 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801494018 | 340b Partners Pharmacy - Dallas LLC | Pharmacy | 2800 S Ih 35 Frontage Rd, Suite 105, Austin, TX 78704 | 2020-10-12 |
1740802206 | Roots, Aba Therapy and Consulting Services LLC | Behavioral Analyst | 3715 S. 1st St, #464, Austin, TX 78704 | 2020-05-07 |
1447896071 | Stefanie Van Hoose Mott | Nurse Practitioner | 2800 South Ih 35 Frontage Road #100, Austin, TX 78704 | 2019-11-19 |
1902463219 | Melanie Rabalais Lpc, Pllc | Counselor | 3111 Dickson Dr, Suite 33, Austin, TX 78704 | 2019-05-22 |
1023590866 | Roberto Carlos Guerra | Physical Therapy Assistant | 2515 S Ih 35, Ste 320, Austin, TX 78704 | 2018-08-29 |
1750875118 | Kristen Gabrielle Ferrante | Dentist | 2330 S Lamar Blvd, Austin, TX 78704 | 2018-06-19 |
1366944555 | Beryl Hoelscher | Registered Nurse | 706 W Ben White Blvd Ste 233a, Austin, TX 78704 | 2018-03-02 |
1780103861 | Remedy Pediatrics Pllc | Pediatrics | 2512 South Interstate 35 Frontage Rd., Suite 310, Austin, TX 78704 | 2017-09-11 |
1285176172 | Leah Nichole Burandt | Physician Assistant | 2512 S Interstate 35 Ste 310, Austin, TX 78704 | 2016-11-09 |
1659822690 | Kristin Jarrett | Physical Therapist | 1524 S I-35, Suite 300, Austin, TX 78704 | 2016-10-14 |
Find all providers in zip 78704 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023616992 | Nancy Toll | Nurse Practitioner | 8600 N Fm 620 Rd Apt 936, Austin, TX 78726-3535 | 2020-10-13 |
1003413055 | Anthony Delovino Lista | Nurse Practitioner | 311 Bowie St Apt 1215, Austin, TX 78703-5296 | 2020-10-02 |
1366049553 | Lauren Nicole Crider | Nurse Practitioner | 3601 S Congress Ave Ste D100, Austin, TX 78704-7205 | 2020-10-01 |
1366059784 | Teresa Marie Reed | Nurse Practitioner | 3921 Steck Ave Ste A120, Austin, TX 78759-8669 | 2020-09-29 |
1144836289 | Amy Silva | Nurse Practitioner | 1824 Rainy Meadows Dr, Austin, TX 78758-3518 | 2020-09-22 |
1326652470 | Carolyn Lee Stanford | Nurse Practitioner | 14902 Crosscreek, Austin, TX 78737-8904 | 2020-09-06 |
1457965899 | Lorie Kmetz | Nurse Practitioner | 1907 Alguno Rd, Austin, TX 78757-3220 | 2020-09-02 |
1184238735 | Amanda Kanski | Nurse Practitioner | 9525 N Capital of Texas Hwy Unit 416, Austin, TX 78759-7294 | 2020-09-01 |
1487265013 | Lisa Karen Brogan | Nurse Practitioner | 1805 Forest Hill Dr, Austin, TX 78745-1720 | 2020-08-17 |
1992316327 | Mona Saberi | Nurse Practitioner | 15024 Calaveras Dr, Austin, TX 78717-4577 | 2020-08-10 |
Find all providers in AUSTIN |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.