Provider Demographics
NPI:1659838555
Name:AUGUSTIN, SHELBY LEIGH (MSN, APRN, FNP-C, RN)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:LEIGH
Last Name:AUGUSTIN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C, RN
Other - Prefix:MRS
Other - First Name:SHELBY
Other - Middle Name:LEIGH
Other - Last Name:AUGUSTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SHELBY HARDEE
Mailing Address - Street 1:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:3101 UNIVERSITY BLVD S STE 102
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2750
Practice Address - Country:US
Practice Address - Phone:904-737-1171
Practice Address - Fax:904-390-7493
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily