Individual ProviderShauntavia WardNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6835 Austin Center Blvd, Austin, TX 78731-3166(512) 346-6611(512) 231-5507PECOS EnrollmentBased on the most recent information from CMS, provider Shauntavia Ward does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:13 AM.Profile DetailsProvider ID1023470689Provider TypeIndividualFull NameWard, ShauntaviaCredentialFNP-CGenderFemaleSole ProprietorNoEnumeration Date3/23/2016Last Updated5/5/2020Contact InformationPractice LocationPractice Address6835 Austin Center Blvd, Austin, TX 78731-3166Phone(512) 346-6611FaxUnlisted FaxMailing LocationMailing Address4515 Seton Center Pkwy Ste 215, Austin, TX 78759-5785Phone(512) 231-5507FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP130140TexasCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95008341CaliforniaProvider IdentifiersIDDescriptionIssuerID380586301DescriptionMedicaidIssuerUnlistedTexasID380586302DescriptionMedicaidIssuerUnlistedTexas