Healthcare Provider Details

I. General information

NPI: 1851575419
Provider Name (Legal Business Name): SHELLY LYNN GERLACH RN, MSN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11180 SPRING HILL DR
SPRING HILL FL
34609-4648
US

IV. Provider business mailing address

PO BOX 506
COUSHATTA LA
71019-0506
US

V. Phone/Fax

Practice location:
  • Phone: 813-915-5459
  • Fax:
Mailing address:
  • Phone: 318-932-2170
  • Fax: 318-932-2242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9301254
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9301254
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: