Healthcare Provider Details

I. General information

NPI: 1518997121
Provider Name (Legal Business Name): JO ANN CARDENAS A.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4107 SPICEWOOD SPRINGS RD STE 100
AUSTIN TX
78759-8645
US

IV. Provider business mailing address

4107 SPICEWOOD SPRINGS RD STE 100
AUSTIN TX
78759-8645
US

V. Phone/Fax

Practice location:
  • Phone: 512-397-3360
  • Fax: 512-343-7107
Mailing address:
  • Phone: 512-397-3360
  • Fax: 512-343-7107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP107209
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP107209
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: