Individual
SHAVONNE M PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
13685 DOCTORS WAY STE 350, FORT MYERS, FL 33912-4347
(239) 343-3800
(239) 343-3993
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-3800
(239) 343-3993
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11020422
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114673000
—
FL
Enumeration date
05/19/2022
Last updated
03/20/2024
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