Individual
MRS. SHOBHA REBALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2617 MITCHAM DR STE 102, TALLAHASSEE, FL 32308-5479
(850) 878-1171
(850) 942-1291
Mailing address
2617 MITCHAM DR STE 102, TALLAHASSEE, FL 32308-5479
(850) 878-1171
(850) 942-1291
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
ARNP9179052
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
ARNP9179052
FL
364SG0600X
Gerontology Clinical Nurse Specialist
ARNP9179052
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018671700
—
FL
05
—
060754100
—
FL
Enumeration date
06/02/2015
Last updated
11/29/2019
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