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General NPI Number Information
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NPI Number | 1619889417
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Entity Type | Individual
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Provider Name | CASSIE SHELTON RN, ESTHETICIAN
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Gender | Female
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 10380 SW VILLAGE CENTER DR STE 276
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City | PORT ST LUCIE
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State | FL
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Zip | 34987-1931
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Country | US
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Telephone | 305-792-8927
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Fax | 305-792-7264
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Provider Business Mailing Address
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Address Line | 10380 SW VILLAGE CENTER DR STE 276
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City | PORT ST LUCIE
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State | FL
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Zip | 34987-1931
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Country | US
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Telephone | 305-792-8927
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Fax | 305-792-7264
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN9328760
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | RN9328760
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | RN9328760
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9328760
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License Number State | FL
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