Shields, Shedrick D

Shields, Shedrick D is an individual health care provider with primary practice located at 3363 Dione St , West Melbourne FL 32904-7582. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Shields, Shedrick D can be contacted via phone (904) 477-3138.

Contact Information

Primary practice address
3363 Dione St West Melbourne FL 32904-7582
Phone: (904) 477-3138
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9168218 Florida

Profile Details

NPI number 1902125446
LBN Legal business name Shields, Shedrick D
Credentials PHD, APRN
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2010
Last updated Mar 26th, 2020 - about 6 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 1902125446 NPPES
Florida MEDICAID 002286300

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