Provider Demographics
NPI:1588986665
Name:SHAWLER, BETTIE ANN (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:BETTIE
Middle Name:ANN
Last Name:SHAWLER
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 E STATE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-3404
Mailing Address - Country:US
Mailing Address - Phone:260-481-2700
Mailing Address - Fax:260-481-2709
Practice Address - Street 1:1529 W LANCASTER ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-1507
Practice Address - Country:US
Practice Address - Phone:260-227-9039
Practice Address - Fax:866-381-4292
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF05210480363LF0000X
IN71012055A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily