Provider Demographics
NPI:1790402089
Name:SHREWSBURY, JAMIE (RN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SHREWSBURY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4709 AMHURST CIR
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-5760
Mailing Address - Country:US
Mailing Address - Phone:913-660-6218
Mailing Address - Fax:
Practice Address - Street 1:4709 AMHURST CIR
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-5760
Practice Address - Country:US
Practice Address - Phone:913-660-6218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9603499163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management