Individual ProviderShaunn AtebaraNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1111 W 34th St, Suite 200, Austin, TX 78705(512) 324-3405(512) 279-6749PECOS EnrollmentBased on the most recent information from CMS, provider Shaunn Atebara 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 6 days ago.Profile DetailsProvider ID1245838705Provider TypeIndividualFull NameAtebara, ShaunnCredentialNPGenderFemaleSole ProprietorNoEnumeration Date10/15/2020Last Updated9/25/2023Contact InformationPractice LocationPractice Address1111 W 34th St, Suite 200, Austin, TX 78705Phone(512) 324-3405Fax(512) 458-5446Mailing LocationMailing Address1111 W 34th St, Suite 200, Austin, TX 78705Phone(512) 279-6749Fax(512) 279-6750Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense1016658TexasProvider IdentifiersIDDescriptionIssuerID42972417DescriptionOtherIssuerTX DLTexas