Provider Demographics
NPI:1487961074
Name:SHENEMAN, DEBBIE CHARLENE (NP-C)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:CHARLENE
Last Name:SHENEMAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 51ST STREET CT W
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-9379
Mailing Address - Country:US
Mailing Address - Phone:941-920-2842
Mailing Address - Fax:813-702-9477
Practice Address - Street 1:308 51ST STREET CT WEST
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-9379
Practice Address - Country:US
Practice Address - Phone:813-759-3385
Practice Address - Fax:813-702-9477
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2221632363LA2200X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013897500Medicaid