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General NPI Number Information
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NPI Number | 1265231104
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Entity Type | Individual
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Provider Name | SHANKEDRU CYREE HARRELL FNP
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Gender | Female
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 8911 N CAPITAL OF TEXAS HWY BLDG 1
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City | AUSTIN
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State | TX
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Zip | 78759-7247
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Country | US
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Telephone | 877-279-5960
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Fax |
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Provider Business Mailing Address
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Address Line | 11602 SUNBURST DR
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City | PAPILLION
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State | NE
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Zip | 68046-5599
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Country | US
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Telephone | 225-678-0540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 115789
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License Number State | NE
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