Provider Demographics
NPI:1346604287
Name:SMELTZER, SHANNON SPENCER (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:SPENCER
Last Name:SMELTZER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3428 N ROOSEVELT BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4224
Mailing Address - Country:US
Mailing Address - Phone:305-901-2243
Mailing Address - Fax:305-901-2243
Practice Address - Street 1:3428 N ROOSEVELT BLVD STE 2
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4224
Practice Address - Country:US
Practice Address - Phone:305-901-2243
Practice Address - Fax:305-901-2243
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9168452163W00000X
FLAPRN9168452163WG0000X
FL9168452363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice