Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | ARNP9301348 | FL |
N | 363LA2100X | Nurse Practitioner - Acute Care | 9301348 | FL |
NPI | 1003309212 |
---|---|
Provider Name | Dr. Shawn Blouin |
First Address | Tampa, FL 33624-7012 |
Second Address | Brandon, FL 33511-5779 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2018 |
Last Update Date | 19/02/2021 |