Individual
JANE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-4363
Mailing address
3622 FOSTER HILL DR N, ST PETERSBURG, FL 33704-1139
(727) 526-6742
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
ARNP1661772
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021158100
—
FL
Enumeration date
05/21/2008
Last updated
01/05/2018
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