Provider Demographics
NPI:1568915643
Name:IRIZARRY-MILLER, SHANNA LEAH (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:SHANNA
Middle Name:LEAH
Last Name:IRIZARRY-MILLER
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:872 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7699
Mailing Address - Country:US
Mailing Address - Phone:407-278-7089
Mailing Address - Fax:
Practice Address - Street 1:872 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7699
Practice Address - Country:US
Practice Address - Phone:407-278-7089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9564296163W00000X
FLAPRN11012990363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse