Provider Demographics
NPI:1881222560
Name:DULIEPE, SHANIKA (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHANIKA
Middle Name:
Last Name:DULIEPE
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 LAKE WORTH RD STE 209-4
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3270
Mailing Address - Country:US
Mailing Address - Phone:754-244-3486
Mailing Address - Fax:
Practice Address - Street 1:5700 LAKE WORTH RD STE 209-4
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3270
Practice Address - Country:US
Practice Address - Phone:754-244-3486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006294363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily