Provider Demographics
NPI:1063553055
Name:SHINKLE, ROSANNE CATHERINE (MN, ARNP)
Entity type:Individual
Prefix:MRS
First Name:ROSANNE
Middle Name:CATHERINE
Last Name:SHINKLE
Suffix:
Gender:F
Credentials:MN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 STOCKPORT ST
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6145
Mailing Address - Country:US
Mailing Address - Phone:407-538-4569
Mailing Address - Fax:
Practice Address - Street 1:237 FERNWOOD BLVD STE 111
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32730-2116
Practice Address - Country:US
Practice Address - Phone:407-332-6506
Practice Address - Fax:407-830-4073
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 524752363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health