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General NPI Number Information
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NPI Number | 1528091998
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Entity Type | Individual
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Provider Name | SHANNEN LEA VIXLER ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 13691 METRO PKWY STE 310
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City | FORT MYERS
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State | FL
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Zip | 33912-4322
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Country | US
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Telephone | 239-768-1400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 984
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City | ESTERO
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State | FL
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Zip | 33929-0984
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Country | US
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Telephone |
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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 | ARNP9198349
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License Number State | FL
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