Sue Ellen Gondran, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP106545 Issued in TX

Practice address

6406 N Ih 35
Ste 2600
Austin, TX 78752-4352

Phone

(512) 465-4800

Fax

(512) 420-0118

NPI assigned

Feb 24, 2006

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

Other identifiers 2

Other names 1

• Miss Sue Ellen Johansson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1366418998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 N IH 35",
            "address_2": "STE 2600",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787524352",
            "telephone_number": "512-465-4800",
            "fax_number": "512-420-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6406 N IH 35",
            "address_2": "STE 2600",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787524352",
            "telephone_number": "512-465-4800",
            "fax_number": "512-420-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONDRAN",
        "first_name": "SUE",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP106545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED PTAN",
            "identifier": "TXB153125",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092886304",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUE",
            "last_name": "JOHANSSON",
            "middle_name": "ELLEN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ruby Annette Gomez, MSN, APRN, FNP-BC
• Sergio Gomez
• Shelly T Gomez
• Tetyana Goncharova
• Kelly Gondek, LCSW
• Guoji Gong, ACUPUNCTURIST.,
• Shaina Wang Gong, MD
• Shantel Nikole Gonsalves, LPC
• Annabelle Gonzales
• Brooklie Benson Gonzales

• Family Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.