Provider Demographics
NPI:1700350832
Name:KRIMMEL, SHAWNON MARIE
Entity Type:Individual
Prefix:
First Name:SHAWNON
Middle Name:MARIE
Last Name:KRIMMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 ROBINSON DR N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-4442
Mailing Address - Country:US
Mailing Address - Phone:727-214-4827
Mailing Address - Fax:727-827-2113
Practice Address - Street 1:900 ROBINSON DR N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-4442
Practice Address - Country:US
Practice Address - Phone:727-214-4827
Practice Address - Fax:727-827-2113
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant