Provider Demographics
NPI:1194564443
Name:KNIPS, SHARDAE EXPOSITO (ARNP)
Entity type:Individual
Prefix:
First Name:SHARDAE
Middle Name:EXPOSITO
Last Name:KNIPS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SHARDAE
Other - Middle Name:EXPOSITO
Other - Last Name:PENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2773 BIRCH TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1332
Mailing Address - Country:US
Mailing Address - Phone:305-336-1809
Mailing Address - Fax:
Practice Address - Street 1:12555 ORANGE DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4304
Practice Address - Country:US
Practice Address - Phone:305-336-1809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11032965363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner