Provider Demographics
NPI:1053156141
Name:GENERAL, KATRINA SHANELL (APRN)
Entity type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:SHANELL
Last Name:GENERAL
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Gender:
Credentials:APRN
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Mailing Address - Street 1:PO BOX 740861
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0861
Mailing Address - Country:US
Mailing Address - Phone:904-819-4539
Mailing Address - Fax:904-819-4906
Practice Address - Street 1:270 PLAZA BLVD STE B5B6
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-9305
Practice Address - Country:US
Practice Address - Phone:904-819-5150
Practice Address - Fax:904-819-5152
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2025-03-27
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11033492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily