Provider Demographics
NPI:1417530585
Name:PARKINSON, SHANNON RENEE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:SHANNON
Middle Name:RENEE
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21352 NE 65TH ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-5707
Mailing Address - Country:US
Mailing Address - Phone:352-361-8229
Mailing Address - Fax:
Practice Address - Street 1:751 SE SYCAMORE TER
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-6216
Practice Address - Country:US
Practice Address - Phone:386-758-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily