Healthcare Provider Details

I. General information

NPI: 1003970476
Provider Name (Legal Business Name): CHRISTEN KAVANAUGH SCHULTE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTEN LEIGH KAVANAUGH LVN, RN

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 COLLIER ST
AUSTIN TX
78704-2911
US

IV. Provider business mailing address

6309 YORK BRIDGE CIR
AUSTIN TX
78749-2273
US

V. Phone/Fax

Practice location:
  • Phone: 512-445-7787
  • Fax: 512-440-4059
Mailing address:
  • Phone: 805-450-3975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number215503
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number855767
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: