Individual
KATIE LOU SHOUPPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,ARNP-FNP
Contact information
Practice address
436 AIRPORT RD STE 20, ARDEN, NC 28704-8403
(407) 200-2352
Mailing address
1341 MEDICAL PARK DR STE 201, MELBOURNE, FL 32901-3235
(321) 768-9914
(321) 768-0033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5015728
NC
363L00000X
Nurse Practitioner
ARNP9350266
FL
363LF0000X
Family Nurse Practitioner
5015728
NC
363LF0000X
Family Nurse Practitioner
Primary
APRN9350266
FL
Other
Enumeration date
06/22/2017
Last updated
08/13/2024
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