=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801628607
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHILOH WEBB FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2024
-----------------------------------------------------
Last Update Date | 09/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1220 N HIGHWAY A1A STE 147
-----------------------------------------------------
City | INDIALANTIC
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32903-2858
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 321-361-5145
-----------------------------------------------------
Fax | 321-951-9127
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3300 S FISKE BLVD
-----------------------------------------------------
City | ROCKLEDGE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32955-4306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 321-361-5145
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APRN11034846
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11034846
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------