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General NPI Number Information
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NPI Number | 1548076045
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Entity Type | Individual
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Provider Name | SHEA MARKS GOLONKA APRN
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Gender | Female
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 1100 GOODLETTE RD
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City | NAPLES
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State | FL
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Zip | 34102-5451
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Country | US
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Telephone | 239-434-0656
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Fax | 239-261-0060
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Provider Business Mailing Address
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Address Line | PO BOX 102222
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City | ATLANTA
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State | GA
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Zip | 30368-2222
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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 | APRN11035641
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License Number State | FL
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