Healthcare Provider Details

I. General information

NPI: 1548914484
Provider Name (Legal Business Name): CASSIE SHENEMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5465 SW 34TH ST
GAINESVILLE FL
32608-5032
US

IV. Provider business mailing address

5465 SW 34TH ST
GAINESVILLE FL
32608-5032
US

V. Phone/Fax

Practice location:
  • Phone: 352-384-3560
  • Fax:
Mailing address:
  • Phone: 352-384-3560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11049116
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: