MEDICARE: AFYA HOUSECALLS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LC1500X	Community Health Nurse Practitioner

General Provider Information

NPI Number	:	1497531396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFYA HOUSECALLS

Provider Business Mailing Address
First Line	:	3373 PABLO CIR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-2160
Country	:	US
Telephone Number	:	913-227-9728
Fax Number	:

Provider Business Practice Location Address
First Line	:	3373 PABLO CIR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-2160
Country	:	US
Telephone Number	:	913-227-9728
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	CAROLINE WANJIKU COWAN
Credential	:
Telephone Number	:	913-227-9728

Provider Enumeration Date	:	09/06/2023
Last Update Date	:	12/11/2023

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