Individual
HEATHER LUTZ SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1005 MAR WALT DRIVE, PEDIATRIC DEPARTMENT, FORT WALTON BEACH, FL 32547-6796
(850) 863-8203
(850) 863-8113
Mailing address
1005 MAR WALT DRIVE, PEDIATRIC DEPARTMENT, FORT WALTON BEACH, FL 32547-6796
(850) 863-8203
(850) 863-8113
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP1951032
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018830000
—
FL
01
—
F0Y5W
BCBSFL
FL
Enumeration date
09/14/2016
Last updated
01/17/2017
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