MICAELA RAE SHANNON

JACKSONVILLE, FL
NPI1023654647
Former NameMICAELA RAE CAMPBELL
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: FL  APRN11015772)
Additional Taxonomies363LP2300X Nurse Practitioner, Primary Care
(Licence: FL  APRN11015772)
163WE0003X Registered Nurse, Emergency
(Licence: FL  RN9469517)
Enumeration Date2019-11-19
Last Update Date2024-03-04
Business Address
MICAELA RAE SHANNON
7016 NORMANDY BLVD
JACKSONVILLE, FL 32205-6206
Phone number: 904-783-2405
Mailing Address
MICAELA RAE SHANNON
2675 WINKLER AVE FL 2
FORT MYERS, FL 33901-9342
Phone number: 877-856-3774