Individual
SHANTELLE BARTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16281 BASS RD STE 304, FORT MYERS, FL 33908-9687
(239) 343-7490
(239) 343-4197
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-7490
(239) 343-4197
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9330396
FL
363LP0200X
Pediatric Nurse Practitioner
95010423
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN9330396
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010291400
—
FL
05
—
115124300
—
FL
Enumeration date
11/22/2013
Last updated
10/10/2022
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