Ailes, Shannette M

Ailes, Shannette M is an individual health care provider with primary practice located at 725 N 12Th Ave Bldg B , Arcadia FL 34266-8752. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Ailes, Shannette M can be contacted via phone (863) 494-1242.

Contact Information

Primary practice address
725 N 12Th Ave Bldg B Arcadia FL 34266-8752
Phone: (863) 494-1242
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71005432A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71005432A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN11012677 Florida

Profile Details

NPI number 1740677210
LBN Legal business name Ailes, Shannette M
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2015
Last updated May 20th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740677210 NPPES
Indiana MEDICAID 201286480
Indiana Other 000000938346
Indiana MEDICAID 0128143

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