Individual
MRS. SHANNON LARGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP, DNP
Contact information
Practice address
4001 SW 13TH STREET, FLORIDA RECOVERY CENTER, GAINESVILLE, FL 32608
(352) 265-5534
Mailing address
4001 SW 13TH STREET, FLORIDA RECOVERY CENTER, GAINESVILLE, FL 32608
(352) 265-5534
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9264277
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009198200
—
FL
Enumeration date
01/05/2011
Last updated
11/06/2013
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