Individual
KELLY MCSHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
4479 ROCKY RIVER RD W FL 32224, JACKSONVILLE, FL 32224-8685
(386) 295-3547
Mailing address
4479 ROCKY RIVER RD W FL 32224, JACKSONVILLE, FL 32224-8685
(386) 295-3547
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11033535
FL
Other
Enumeration date
06/21/2024
Last updated
06/26/2024
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