Healthcare Provider Details

I. General information

NPI: 1326365222
Provider Name (Legal Business Name): SHONDA RENEE JANKE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2010
Last Update Date: 03/21/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 3310, 0
APO NY
09180
US

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 3310,0
APO AE
09180-3100
US

V. Phone/Fax

Practice location:
  • Phone: 512-528-2100
  • Fax:
Mailing address:
  • Phone: 314-636-9051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberP3174
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberP3173
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: