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General NPI Number Information
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NPI Number | 1598926230
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Entity Type | Individual
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Provider Name | JEANETTE MARJORIE SHANHOLTZER RNC MSN APRN WHNP
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Gender | Female
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 1535 NE DOUGLAS ST
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City | LEES SUMMIT
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State | MO
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Zip | 64086-4611
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Country | US
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Telephone | 816-525-0907
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Fax | 816-525-1664
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Provider Business Mailing Address
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Address Line | PO BOX 1465
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-1465
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Country | US
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Telephone | 816-719-5109
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 9402822
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License Number State | FL
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