Individual provider · Type 1 NPI

Justin K. Sandefur

Pediatric Nurse Practitioner · Austin, TX

NPI number 1497222400 Active

Practice location

4900 Mueller Blvd
Austin, TX 78723-3079

Mailing address

4624 Page St
Austin, TX 78723-5484

Specialties and licenses

TaxonomyCodeLicense
Pediatric Critical Care Medicine Physician 2080P0203XAP139467 (TX)
Acute Care Nurse Practitioner 363LA2100XAP139467 (TX)
Pediatric Nurse Practitioner Primary 363LP0200XAP139467 (TX)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1497222400

Justin K. Sandefur's National Provider Identifier is 1497222400, issued on Oct 28, 2018. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Austin, TX. The record was last updated on Mar 25, 2025.