Provider Demographics
NPI:1083796940
Name:SHOTWELL, JENNIFER LEA MYERS (MSN CPNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEA MYERS
Last Name:SHOTWELL
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Gender:F
Credentials:MSN CPNP
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Mailing Address - Street 1:PO BOX 6149
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-6149
Mailing Address - Country:US
Mailing Address - Phone:808-887-6543
Mailing Address - Fax:808-887-6294
Practice Address - Street 1:64-1032 MAMALAHOA HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8441
Practice Address - Country:US
Practice Address - Phone:808-887-6543
Practice Address - Fax:808-887-6294
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2016-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HI270363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics