MEDICARE: MS. HEATHER ERIN SHONK MSN, APRN, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN9422493	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053839399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEATHER ERIN SHONK MSN, APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	15017 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-1816
Country	:	US
Telephone Number	:	813-694-2401
Fax Number	:	888-638-3664

Provider Business Practice Location Address
First Line	:	15017 N DALE MABRY HWY # 1008
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-1816
Country	:	US
Telephone Number	:	813-694-2401
Fax Number	:	888-638-3664

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2017
Last Update Date	:	11/10/2025

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