Basic Information
Provider Information
NPI: 1780022590
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAPILLON ANDERSON
FirstName: SHELA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: MSN, RN, ANP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1545 9TH ST SW
Address2:  
City: VERO BEACH
State: FL
PostalCode: 329624312
CountryCode: US
TelephoneNumber: 7722578224
FaxNumber: 7722133157
Practice Location
Address1: 1553 US HIGHWAY 1
Address2:  
City: VERO BEACH
State: FL
PostalCode: 329605735
CountryCode: US
TelephoneNumber: 7722578224
FaxNumber: 7722133157
Other Information
ProviderEnumerationDate: 06/13/2013
LastUpdateDate: 11/21/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XARNP 9236018FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

ID Information
IDTypeStateIssuerDescription
ARNP923601801FLSTATE LICENSEOTHER


Home