Individual ProviderShanna BarryNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3200 Red River St Ste 201, Austin, TX 78705-2655(855) 481-8375(512) 324-4973PECOS EnrollmentBased on the most recent information from CMS, provider Shanna Barry is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1245241066Provider TypeIndividualFull NameBarry, ShannaTitleMs.CredentialN.P.GenderFemaleSole ProprietorNoEnumeration Date8/10/2006Last Updated9/20/2023Contact InformationPractice LocationPractice Address3200 Red River St Ste 201, Austin, TX 78705-2655Phone(855) 481-8375FaxUnlisted FaxMailing LocationMailing Address3706 S 1st St, Austin, TX 78704-7046Phone(512) 324-4973Fax(512) 324-4948Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP114625TexasCode363L00000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense613974TexasProvider IdentifiersIDDescriptionIssuerID111433201DescriptionOtherIssuerMEDICAID EPSDTTexas