Shannon Nichole Groleau
Nurse Practitioner - Adult Health
1325 San Marco Blvd Ste 4a
Jacksonville
, Florida 32207-8568
Shannon Nichole Groleau
Nurse Practitioner - Adult Health
1325 San Marco Blvd Ste 4a
Jacksonville
, Florida 32207-8568
(904) 306-9864
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About
Features
Specialties
- Nurse Practitioner - Adult Health
Languages spoken
- English
Location
First Address
- Shannon Nichole Groleau
- Po Box 57970
- Jacksonville, FL
- Zip : 32241-7970
- Fax : (904) 306-9864
- Phone : (904) 306-9860
Second Address
- Shannon Nichole Groleau
- 1325 San Marco Blvd Ste 4a
- Jacksonville, FL
- Zip : 32207-8568
- Fax : (904) 306-9864
- Phone : (904) 306-9860
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2200X | Nurse Practitioner - Adult Health | ARNP9207713 | FL |
National Provider Identifier
| NPI | 1023254299 |
|---|---|
| Provider Name | Shannon Nichole Groleau |
| First Address | Jacksonville, FL 32241-7970 |
| Second Address | Jacksonville, FL 32207-8568 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/12/2008 |
| Last Update Date | 12/06/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| ARNP9207713 | (05) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.