Individual
MISS MARY SHIMKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
421 SE ALFRED MARKHAM ST, LAKE CITY, FL 32025
(386) 697-1364
(888) 370-3379
Mailing address
421 SE ALFRED MARKHAM ST, LAKE CITY, FL 32025
(386) 697-1364
(888) 370-3379
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
191552
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11002284
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NC
Enumeration date
10/06/2006
Last updated
07/12/2019
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