Provider Demographics
NPI:1326645607
Name:SHAVER, RACHEL JOAN (FNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:JOAN
Last Name:SHAVER
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1574 HERITAGE LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2082
Mailing Address - Country:US
Mailing Address - Phone:765-602-4566
Mailing Address - Fax:
Practice Address - Street 1:32 OCEAN DR
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-4034
Practice Address - Country:US
Practice Address - Phone:765-602-4566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9454685163WE0003X
CA95033113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency