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General NPI Number Information
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NPI Number | 1942713888
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Entity Type | Individual
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Provider Name | SHAYLA RAE ARNP
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Gender | Female
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Dates
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Enumeration Date | 11/14/2017
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 186 SOUTHERN OAK DR
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City | PONTE VEDRA
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State | FL
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Zip | 32081-8365
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Country | US
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Telephone | 641-919-8889
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Fax |
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Provider Business Mailing Address
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Address Line | 16 PINDO PALM DR
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City | PONTE VEDRA
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State | FL
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Zip | 32081-6085
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Country | US
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Telephone | 641-919-8889
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 131158
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | B131158
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | F131158
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License Number State | IA
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