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SHANISHA BROWN ARNP

Gerontology >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1376084434

Individual Registrant:
 SHANISHA  BROWN ARNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
12940 LAKE VISTA DR  GIBSONTON, FL 33534-3901 US
Tel: 813-390-2679  Fax: --

Contact information for business:
12940 LAKE VISTA DR  GIBSONTON, FL 33534-3901 US
Tel: --  Fax: --

Registration Information:
NPI: 1376084434
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LG0600XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Gerontology
FL9304179

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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