MEDICARE: DEBBIE C. SHENEMAN NP-C INC

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	363LA2200X	Adult Health Nurse Practitioner
2	261QM2500X	Medical Specialty Clinic/Center	2221632	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	:	1639587728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEBBIE C. SHENEMAN NP-C INC

Provider Business Mailing Address
First Line	:	926 14TH ST W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34205-6646
Country	:	US
Telephone Number	:	813-759-3385
Fax Number	:	813-702-9477

Provider Business Practice Location Address
First Line	:	926 14TH ST W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34205-6646
Country	:	US
Telephone Number	:	813-759-3385
Fax Number	:	813-702-9477

Authorized Official
Title or Position	:	OWNER
Name	:	DEBBIE C. SHENEMAN
Credential	:	NP-C
Telephone Number	:	941-920-2842

Provider Enumeration Date	:	08/01/2014
Last Update Date	:	03/06/2020

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