Provider Demographics
NPI:1003970476
Name:SCHULTE, CHRISTEN KAVANAUGH (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:KAVANAUGH
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHRISTEN
Other - Middle Name:LEIGH
Other - Last Name:KAVANAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN, RN
Mailing Address - Street 1:6309 YORK BRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-2273
Mailing Address - Country:US
Mailing Address - Phone:805-450-3975
Mailing Address - Fax:
Practice Address - Street 1:1430 COLLIER ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-2911
Practice Address - Country:US
Practice Address - Phone:512-445-7787
Practice Address - Fax:512-440-4059
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA215503164W00000X
TX855767163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse