Provider Demographics
NPI:1427845320
Name:BLUTCHER, SHONTEL ROSHEL (CNA376211)
Entity type:Individual
Prefix:
First Name:SHONTEL
Middle Name:ROSHEL
Last Name:BLUTCHER
Suffix:
Gender:
Credentials:CNA376211
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22632 BLUE FIN TRL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4642
Mailing Address - Country:US
Mailing Address - Phone:561-667-9944
Mailing Address - Fax:
Practice Address - Street 1:219 SW 12TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-1535
Practice Address - Country:US
Practice Address - Phone:561-667-9944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide