Most Relevant Information
Provider Data
| NPI Number: | 1003542549 |
| Provider Name: | SHARA LANECIA MCPHALL PMHNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN11020143 |
Most Important Dates
| Enumeration Date: | 07/27/2022 |
| Last Updated: | 07/27/2022 |
Provider Practice Location
1542 KINGSLEY AVE STE 136
ORANGE PARK
FL
320734547
Practice Location Phone/Fax
| Phone: | 2392232751 |
| Fax: |
Provider Mailing Location
4310 METRO PKWY STE 205
FORT MYERS
FL
339169416
Provider Mailing Phone/Fax
| Phone: | 2392368784 |
| Fax: | 2397902624 |