MEDICARE: MRS. KAREN P SHIELDS ARNP

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	363L00000X	Nurse Practitioner	ARNP2131882	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	:	1477507101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN P SHIELDS ARNP

Provider Business Mailing Address
First Line	:	5700 LAKE WORTH RD
Second Line	:	# 204
City	:	GREENACRES
State	:	FL
Zip	:	33463-4727
Country	:	US
Telephone Number	:	561-968-7968
Fax Number	:	561-964-4603

Provider Business Practice Location Address
First Line	:	5401 S CONGRESS AVE
Second Line	:	# 102
City	:	ATLANTIS
State	:	FL
Zip	:	33462-6635
Country	:	US
Telephone Number	:	561-967-5033
Fax Number	:	561-968-7968

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	07/08/2007

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