Individual
SHANNON MILLER MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
14055 RIVEREDGE DR STE 250, TAMPA, FL 33637-2141
(813) 929-5451
(813) 929-5465
Mailing address
2600 BRUCE B DOWNS BLVD, WESLEY CHAPEL, FL 33544-9207
(813) 446-5780
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN11031067
FL
Other
Enumeration date
02/12/2024
Last updated
09/23/2025
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