Provider Demographics
NPI:1639587728
Name:DEBBIE C. SHENEMAN NP-C INC
Entity Type:Organization
Organization Name:DEBBIE C. SHENEMAN NP-C INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHENEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:941-920-2842
Mailing Address - Street 1:926 14TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-6646
Mailing Address - Country:US
Mailing Address - Phone:813-759-3385
Mailing Address - Fax:813-702-9477
Practice Address - Street 1:926 14TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-6646
Practice Address - Country:US
Practice Address - Phone:813-759-3385
Practice Address - Fax:813-702-9477
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEBBIE C. SHENEMAN NP-C LLC HEALTHCARE CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-01
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2221632261QM2500X
363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013897500Medicaid
FLHU695ZMedicare PIN