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General NPI Number Information
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NPI Number | 1558285510
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Entity Type | Individual
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Provider Name | SHIMERE RENEE JACKSON DNP, APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 105 N ALEXANDER ST STE 105
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City | PLANT CITY
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State | FL
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Zip | 33563-4831
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Country | US
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Telephone | 813-755-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 8626 HOLLY GROVE CT
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City | RIVERVIEW
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State | FL
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Zip | 33578-5095
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Country | US
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Telephone | 813-475-9057
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11049790
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License Number State | FL
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