1417266792 NPI number — SHAWN M. ALBERS APRN-FNP

Table of content: SHAWN M. ALBERS APRN-FNP (NPI 1417266792)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417266792 NPI number — SHAWN M. ALBERS APRN-FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBERS
Provider First Name:
SHAWN
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN-FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROWN
Provider Other First Name:
SHAWN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN-FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1417266792
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
C/O 8307 KNIGHT ROAD
Provider Second Line Business Mailing Address:
8307 KNIGHT ROAD
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77054-3905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-242-7707
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1319 PUNAHOU ST
Provider Second Line Business Practice Location Address:
SUITE 990
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96826-1001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-682-9162
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/04/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  1526 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: 644410 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 284017501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 848N64 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".