Shotwell, Jessica
Shotwell, Jessica is an individual health care provider with primary practice located at 4196 W Us Highway 90 Ste 105 , Lake City FL 32055-8834. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Shotwell, Jessica can be contacted via phone (386) 243-8474.Contact Information
Primary practice address
4196 W Us Highway 90 Ste 105
Lake City FL 32055-8834
Phone: (386) 243-8474
Fax: (386) 438-5945
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | ARNP9220069 | Florida |
Profile Details
NPI number | 1710966346 |
---|---|
LBN Legal business name | Shotwell, Jessica |
Credentials | ARNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 12th, 2006 |
Last updated | Jul 10th, 2013 - about 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1710966346 | NPPES |
Florida | MEDICAID | 307391200 |
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