Provider Demographics
NPI:1164906715
Name:SHIMP, LAUREN (ARNP, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:SHIMP
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6063
Mailing Address - Fax:904-539-4091
Practice Address - Street 1:180 N WATERSOUND PKWY
Practice Address - Street 2:
Practice Address - City:INLET BEACH
Practice Address - State:FL
Practice Address - Zip Code:32461-7274
Practice Address - Country:US
Practice Address - Phone:850-278-3551
Practice Address - Fax:850-278-3596
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9338033363L00000X
FLARNP9338033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner