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:
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Health care specialties

SpecialtyCodeLicense #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 13 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 1710966346 NPPES
Florida MEDICAID 307391200

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