Shelton, Heather Lutz

Shelton, Heather Lutz is an individual health care provider with primary practice located at 1005 Mar Walt Drive Pediatric Department, Fort Walton Beach FL 32547-6796. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Shelton, Heather Lutz can be contacted via phone (850) 863-8203.

Contact Information

Primary practice address
1005 Mar Walt Drive Pediatric Department Fort Walton Beach FL 32547-6796
Phone: (850) 863-8203
Fax: (850) 863-8113
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP1951032 Florida

Profile Details

NPI number 1083162457
LBN Legal business name Shelton, Heather Lutz
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2016
Last updated Jan 17th, 2017 - about 9 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 1083162457 NPPES
Florida Other F0Y5W BCBSFL
Florida MEDICAID 018830000 BCBSFL

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