AGNP-C Shannon Boodhwani, NPI 1841739018
Adult Health Nurse Practitioner in Fort Worth, TX, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1841739018
NPI Entity Type Individual
Provider Name AGNP-C Shannon Boodhwani
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 6100 Harris Pkwy Ste 345, Fort Worth, TX, US
Provider Mailing Address 6100 Harris Pkwy Ste 345, Fort Worth, TX, US, 761324134
Is Sole Proprietor? No
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Primary Taxonomy

Taxonomy Code

363LA2200X

Taxonomy Name Adult Health Nurse Practitioner
Classification

Nurse Practitioner

Group

Physician Assistants & Advanced Practice Nursing Providers

License No. AP133009
License State TX
Description Definition to come...

Other Name

Shannon Willenberg
Former Name

Business Address

AGNP-C Shannon Boodhwani
6100 Harris Pkwy Ste 345

Fort Worth, TX, US

Phone: 817-346-5960
Fax: 817-346-5961

Mailing Address

AGNP-C Shannon Boodhwani
6100 Harris Pkwy Ste 345
Fort Worth, TX, US
ZIP 761324134
Phone: 817-346-5960
Fax: 817-346-5961

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

363LF0000X

Physician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

744136 TX No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
370193002 TX MEDICAID 05
370193003 TX CSHCN 01

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Organization

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Organization

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