Provider Demographics
NPI:1437932175
Name:SHELTON, JOYCE AIESHA (APRN)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:AIESHA
Last Name:SHELTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8557 NW 19TH RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-9234
Mailing Address - Country:US
Mailing Address - Phone:352-642-4044
Mailing Address - Fax:
Practice Address - Street 1:720 SW 2ND AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6271
Practice Address - Country:US
Practice Address - Phone:352-642-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty