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General NPI Number Information
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NPI Number | 1407159924
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Entity Type | Individual
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Provider Name | SHAWNA L LANGLEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 820 GOODLETTE RD N
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City | NAPLES
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State | FL
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Zip | 34102-5445
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Country | US
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Telephone | 239-434-0166
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Fax | 239-434-7553
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Provider Business Mailing Address
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Address Line | 2160 COLONIAL BLVD
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City | FORT MYERS
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State | FL
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Zip | 33907-1410
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | PA9105812
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9105812
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License Number State | FL
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