Provider Demographics
NPI:1992736110
Name:DORAN, SHAWNA ANN (ARNP)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:ANN
Last Name:DORAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6228 NW 43RD ST
Mailing Address - Street 2:STE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-8871
Mailing Address - Country:US
Mailing Address - Phone:352-871-1995
Mailing Address - Fax:
Practice Address - Street 1:14415 NW 144TH PL
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-5270
Practice Address - Country:US
Practice Address - Phone:352-871-1995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1557262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y6565XOtherBCBS
Y6565XOtherBCBS
Y6565XMedicare ID - Type Unspecified