Provider Demographics
NPI:1659904449
Name:HARVILLE, SHANNON HASSETT (APRN)
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:HASSETT
Last Name:HARVILLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3113 LAWTON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3519
Mailing Address - Country:US
Mailing Address - Phone:407-894-3241
Mailing Address - Fax:407-896-9863
Practice Address - Street 1:3113 LAWTON RD STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3519
Practice Address - Country:US
Practice Address - Phone:407-894-3241
Practice Address - Fax:407-896-9863
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9435702163WE0003X
FLAPRN11016527363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency