Provider Demographics
NPI:1992546410
Name:SHURDEN, JAIMIE SUE (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:JAIMIE
Middle Name:SUE
Last Name:SHURDEN
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E 4TH ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-3156
Mailing Address - Country:US
Mailing Address - Phone:512-648-9945
Mailing Address - Fax:
Practice Address - Street 1:120 E 4TH ST UNIT 1
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3156
Practice Address - Country:US
Practice Address - Phone:512-648-9945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11033273363LF0000X
VA0024190528363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily