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General NPI Number Information
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NPI Number | 1053949941
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Entity Type | Individual
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Provider Name | SHAWN NIXON APRN
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Gender | Male
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Dates
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Enumeration Date | 03/28/2020
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 5151 WINTER GARDEN VINELAND RD STE 208
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City | WINDERMERE
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State | FL
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Zip | 34786-6098
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Country | US
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Telephone | 407-636-7802
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Fax |
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Provider Business Mailing Address
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Address Line | 5151 WINTER GARDEN VINELAND RD
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City | WINDERMERE
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State | FL
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Zip | 34786-6098
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Country | US
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Telephone | 407-636-7802
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.026573
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN11023852
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License Number State | FL
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