Provider Demographics
NPI:1023880622
Name:SHOPP, ASHLEY M (CNM)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:SHOPP
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-7130
Mailing Address - Fax:239-343-7185
Practice Address - Street 1:9800 S HEALTHPARK DR STE 205
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3630
Practice Address - Country:US
Practice Address - Phone:239-343-7130
Practice Address - Fax:239-343-7185
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029428367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife