Agenbroad-Elander, Shawn R
Agenbroad-Elander, Shawn R is an individual health care provider with primary practice located at 4303 Victory Dr , Austin TX 78704-7507. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Agenbroad-Elander, Shawn R can be contacted via phone (512) 462-3627.Contact Information
Primary practice address
4303 Victory Dr
Austin TX 78704-7507
Phone: (512) 462-3627
Fax: (512) 462-2898
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP118041 | Texas |
Profile Details
| NPI number | 1164655171 |
|---|---|
| LBN Legal business name | Agenbroad-Elander, Shawn R |
| Credentials | FNP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2009 |
| Last updated | Jan 10th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164655171 | NPPES |
| Texas | Other | AP118041 | LICENSE |
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