Individual
JANINE MARIE SHIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
102 HONEYSUCKLE DR, WILDWOOD, FL 34785-9700
(352) 572-8650
Mailing address
102 HONEYSUCKLE DR, WILDWOOD, FL 34785-9700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2951712
FL
163W00000X
Registered Nurse
798644
CA
163W00000X
Registered Nurse
RN2284978
MA
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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