Provider Demographics
NPI:1740685627
Name:SEARS, SHANDELL (RN)
Entity type:Individual
Prefix:
First Name:SHANDELL
Middle Name:
Last Name:SEARS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SHANDELL
Other - Middle Name:LYN
Other - Last Name:STECKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32701 NORTH RANCH ROAD 12 #A
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620
Mailing Address - Country:US
Mailing Address - Phone:512-584-6304
Mailing Address - Fax:
Practice Address - Street 1:3409 EXECUTIVE CENTER DR STE 113
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1619
Practice Address - Country:US
Practice Address - Phone:512-359-3703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX663488251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health