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General NPI Number Information
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NPI Number | 1184299703
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Entity Type | Individual
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Provider Name | JAIME SHUMATE APRN
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Gender | Female
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 17644 HAMLIN BLVD
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-2677
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Country | US
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Telephone | 931-436-8055
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Fax |
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Provider Business Mailing Address
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Address Line | 3347 S STATE ROAD 7 STE 203
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City | WELLINGTON
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State | FL
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Zip | 33449-8148
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Country | US
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Telephone | 561-635-6738
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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 | APRN11012547
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License Number State | FL
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