Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | ARNP 1426582 | FL |
NPI | 1235663303 |
---|---|
Provider Name | Vickie Chapman-Shaw |
First Address | Jacksonville, FL 32258-2460 |
Second Address | Jacksonville, FL 32258-2460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2017 |
Last Update Date | 17/04/2017 |