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General NPI Number Information
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NPI Number | 1346604287
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Entity Type | Individual
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Provider Name | SHANNON SPENCER SMELTZER APRN
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Gender | Female
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 3720 N ROOSEVELT BLVD
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City | KEY WEST
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State | FL
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Zip | 33040-4533
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Country | US
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Telephone | 305-514-0482
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Fax | 949-577-4701
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Provider Business Mailing Address
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Address Line | 3428 N ROOSEVELT BLVD STE 2
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City | KEY WEST
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State | FL
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Zip | 33040-4224
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Country | US
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Telephone | 305-901-2243
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Fax | 305-901-2243
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 9168452
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | APRN9168452
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | IAPRN9168452
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License Number State | FL
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