MRS. JESSICA SHACKLETT (NPI# 1467067371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467067371 |
| Entity Type | Individual |
| Full Name | MRS. JESSICA SHACKLETT |
| Credential | APRN |
| Practice Address |
206 2nd St E Bradenton FL 34208-1042 |
| Mailing Address |
6414 Spyglass Ln Bradenton FL 34202-1707 |
| Practice Telephone | 9417465111 |
| Mailing Telephone | 9417046491 |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
11009058 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
206 2ND ST E |
| City | BRADENTON |
| State | FL |
| Zip Code | 34208-1042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275522997 | Lawrence George Manco | Radiology | 206 2nd St E, Bradenton, FL 34208-1042 | 2005-10-14 |
| 1801494117 | Sarah Louise Harper | Student in an Organized Health Care Education/Training Program | 206 2nd St E, Bradenton, FL 34208-1042 | 2020-10-09 |
| 1528680808 | Harrison Browning | Student in an Organized Health Care Education/Training Program | 206 2nd St E, Bradenton, FL 34208-1042 | 2020-05-10 |
| 1467073254 | Juan Dangond Gomez | Student in an Organized Health Care Education/Training Program | 206 2nd St E, Bradenton, FL 34208-1042 | 2020-05-03 |
| 1821619289 | Maniekha Maharaj | Student in an Organized Health Care Education/Training Program | 206 2nd St E, Bradenton, FL 34208-1042 | 2020-04-27 |
| 1063033447 | Melissa Vilar | Student in an Organized Health Care Education/Training Program | 206 2nd St E, Bradenton, FL 34208-1000 | 2020-04-27 |
| 1659991040 | Klaudio Alla | Student in an Organized Health Care Education/Training Program | 206 2nd St E, Bradenton, FL 34208-1042 | 2020-04-26 |
| 1376163733 | Ahmed Ali Alhassani | Student in an Organized Health Care Education/Training Program | 206 2nd St E, Bradenton, FL 34208-1000 | 2020-04-25 |
| 1821618331 | Shivan Ramsamooj | Student in an Organized Health Care Education/Training Program | 206 2nd St E, Bradenton, FL 34208-1042 | 2020-04-24 |
| 1598385320 | Lily Schuneman | Student in an Organized Health Care Education/Training Program | 206 2nd St E, Bradenton, FL 34208-1042 | 2020-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740880566 | Michael Gerard Kulikowski | Pharmacist | 6225 E Sr 64, Bradenton, FL 34208 | 2020-10-30 |
| 1104431964 | Genesis Carrillo | Pharmacist | 4210 E, Fl-64, Bradenton, FL 34208 | 2020-09-09 |
| 1962960146 | Elite Surgery Center, LLC | Plastic Surgery | 5301 4th Ave Circle E, Bradenton, FL 34208 | 2019-03-07 |
| 1740777101 | Chinelo Uche | Student in an Organized Health Care Education/Training Program | 206 2nd St. E, Brandenton, FL 34208 | 2018-04-20 |
| 1396240040 | Nicholas Guy Ross | Student in an Organized Health Care Education/Training Program | 206 2nd St E., Bradenton, FL 34208 | 2018-03-26 |
| 1881196566 | Pinnacle Dental, Inc | Dentist | 5220 4th Ave. Circle E., Bradenton, FL 34208 | 2018-03-08 |
| 1194240176 | Bradenton Community Acupuncture | Acupuncturist | 5245 Office Park Blvd Suite 103, Bradenton, FL 34208 | 2017-08-10 |
| 1316490147 | Loretta Michele Deloach | Counselor | 515 27th St. S., Ste. 3, Bradenton, FL 34208 | 2016-07-28 |
| 1730548934 | Elodie Chimuanya Epane Kamdem | Dentist | Bright Now Dentalst, 650, 3611 1st Street, Suiyr, Bradenton, FL 34208 | 2016-02-16 |
| 1215303920 | Lesley Ann White | Driver | 45 Palmwood, Bradenton, FL 34208 | 2015-08-17 |
| Find all providers in zip 34208 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208494 | Abby Elizabeth Crews | Nurse Practitioner | 7534, Divot Loop, Bradenton, FL 34202 | 2020-09-01 |
| 1568002459 | South Florida Injury and Convenient Care | Nurse Practitioner | 2601 Manatee Ave W Ste E, Bradenton, FL 34205-4942 | 2020-01-09 |
| 1033758917 | Brooke Ariel Talbert | Nurse Practitioner | 1803 5th St W, Bradenton, FL 34205-8303 | 2019-12-25 |
| 1912550476 | Vilma Rodriguez | Nurse Practitioner | 1200 37th Ave E, Bradenton, FL 34208-4553 | 2019-07-23 |
| 1366008930 | Mary Janell Hostetler | Nurse Practitioner | 11611 Brookside Dr, Bradenton, FL 34211-4525 | 2019-05-19 |
| 1144886177 | Jewel Tartt | Nurse Practitioner | 1001 13th Avenue East, Medical Department, Bradenton, FL 34208-3420 | 2019-05-15 |
| 1336607522 | Katrina Onyx Wilson | Nurse Practitioner | 304 74th Street Ct Nw, Bradenton, FL 34209-2220 | 2019-03-06 |
| 1184193047 | Mary Kathleen Dufek | Nurse Practitioner | 8610 State Road 70 E, Bradenton, FL 34202-3785 | 2018-11-20 |
| 1255840922 | Megan Fallon | Nurse Practitioner | 250 2nd St E Ste 3b, Bradenton, FL 34208-1027 | 2017-09-26 |
| 1639604556 | Jodie Lynn Dodge | Nurse Practitioner | 8614 State Road 70 E Ste 200, Bradenton, FL 34202-3710 | 2017-04-28 |
| Find all providers in BRADENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.