Shanna Gaetjen

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

171298 Issued in TX

Practice address

1101 Wilson Rd Apt 112
Conroe, TX 77301-1609

Phone

(936) 777-1144

NPI assigned

Sep 5, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1053960708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 DAIRY ASHFORD RD STE 560",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770793035",
            "telephone_number": "713-799-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 WILSON RD APT 112",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011609",
            "telephone_number": "936-777-1144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Wilson Rd Apt 112",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773011609",
            "country_code": "US",
            "telephone_number": "936-777-1144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAETJEN",
        "first_name": "SHANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "171298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Fuller, LPC
• Leslie Fullerton, D.D.S.
• James Michael Fulton, D.D.S.
• Haylee Ann Furlow, M.A., LPC
• Shreya Gade
• David Foster Gage
• Brooks Gagne
• Alanna Karyn Gale, FNP-C
• Vasantha Lakshmi Gali, MD
• Eduardo Galvez

• Licensed Vocational Nurse in Conroe, TX
• Providers in Conroe, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.