Individual
MRS. BETHANY SHOVLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, RN, RD
Contact information
Practice address
807 CHILDRENS WAY, NEMOURS CHILDRENS SPECIALTY CARE, JACKSONVILLE, JACKSONVILLE, FL 32207-8426
(904) 697-3660
(904) 697-3927
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9443636
FL
363LP0200X
Pediatric Nurse Practitioner
SP011513
PA
Other
Enumeration date
11/22/2011
Last updated
02/09/2017
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