Provider Demographics
NPI:1487940912
Name:SHAPIRO, SANDRA D (MSN, CNL, ARNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:D
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MSN, CNL, ARNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4539 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-4738
Mailing Address - Country:US
Mailing Address - Phone:904-633-0300
Mailing Address - Fax:
Practice Address - Street 1:4539 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-4738
Practice Address - Country:US
Practice Address - Phone:904-633-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9206722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily