Provider Demographics
NPI:1316698327
Name:BATIE, SHARDAE LYNETTE (APRN)
Entity type:Individual
Prefix:MRS
First Name:SHARDAE
Middle Name:LYNETTE
Last Name:BATIE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SHARDAE
Other - Middle Name:LYNETTE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6314
Mailing Address - Country:US
Mailing Address - Phone:407-268-6469
Mailing Address - Fax:
Practice Address - Street 1:1200 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-6314
Practice Address - Country:US
Practice Address - Phone:407-244-8559
Practice Address - Fax:888-272-9531
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11006067363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily