Provider Demographics
NPI:1114460151
Name:KROLL, SHAUNA (NP-C)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:KROLL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:
Other - Last Name:KURZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:495 10TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-3163
Mailing Address - Country:US
Mailing Address - Phone:830-393-0235
Mailing Address - Fax:830-393-0413
Practice Address - Street 1:495 10TH ST STE 104
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-3163
Practice Address - Country:US
Practice Address - Phone:830-393-0235
Practice Address - Fax:830-393-0413
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX802948363LF0000X
TXAP132649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily