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General NPI Number Information
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NPI Number | 1760115398
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Entity Type | Individual
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Provider Name | KINDALL NICOLE HOLLOWELL SHEDRICK APRN
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Gender | Female
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 225 W STATE ROAD 434 STE 203
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City | LONGWOOD
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State | FL
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Zip | 32750-4980
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Country | US
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Telephone | 844-699-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 206 REGAL DOWNS CIR
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City | WINTER GARDEN
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State | FL
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Zip | 34787-4016
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11020558
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License Number State | FL
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