Individual
JESSICA SHOTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4196 W US HIGHWAY 90 STE 105, LAKE CITY, FL 32055-8834
(386) 243-8474
(386) 438-5945
Mailing address
4196 W US HIGHWAY 90 STE 105, LAKE CITY, FL 32055-8834
(386) 243-8474
(386) 438-5945
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9220069
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307391200
—
FL
Enumeration date
01/12/2006
Last updated
07/10/2013
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