Provider Demographics
NPI:1548867559
Name:TURNER-ANDERSON, SHANNON N (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:N
Last Name:TURNER-ANDERSON
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:MRS
Other - First Name:SHANNON
Other - Middle Name:N
Other - Last Name:TURNER-ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, APRN, PMHNP-BC
Mailing Address - Street 1:2824 WINDGUARD CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7369
Mailing Address - Country:US
Mailing Address - Phone:813-995-5682
Mailing Address - Fax:813-501-4035
Practice Address - Street 1:2824 WINDGUARD CIR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7369
Practice Address - Country:US
Practice Address - Phone:813-995-5682
Practice Address - Fax:813-501-4035
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021488363LP0808X
FLRN9343475163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL117515500Medicaid