Provider Demographics
NPI:1053839399
Name:SHONK, HEATHER ERIN (MSN, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:ERIN
Last Name:SHONK
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14499 N DALE MABRY HWY STE 130S
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2071
Mailing Address - Country:US
Mailing Address - Phone:813-530-1414
Mailing Address - Fax:
Practice Address - Street 1:14499 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2078
Practice Address - Country:US
Practice Address - Phone:813-530-1414
Practice Address - Fax:813-556-2231
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9422493363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health