Healthcare Provider Details

I. General information

NPI: 1861579492
Provider Name (Legal Business Name): SHAWNA A WARREN APRN, BC, ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E 15TH ST
AUSTIN TX
78701-1930
US

IV. Provider business mailing address

1240 BARTON HILLS DR #119
AUSTIN TX
78704-2080
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-7000
  • Fax:
Mailing address:
  • Phone: 512-326-3348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number693287
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: