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General NPI Number Information
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NPI Number | 1144010927
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Entity Type | Individual
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Provider Name | KRISTEN LEE SHOTWELL APRN
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Gender | Female
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 2141 S ALT A1A STE 420
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City | JUPITER
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State | FL
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Zip | 33477-4063
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Country | US
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Telephone | 561-743-5580
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Fax |
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Provider Business Mailing Address
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Address Line | 4580 SE FEDERAL HWY APT 7410
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City | STUART
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State | FL
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Zip | 34997-5783
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Country | US
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Telephone | 561-222-3848
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11039317
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License Number State | FL
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