Provider Demographics
NPI:1053801381
Name:SHULER, ANGELA LOVETT
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LOVETT
Last Name:SHULER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 BLUEGRASS PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2361
Mailing Address - Country:US
Mailing Address - Phone:502-568-7364
Mailing Address - Fax:502-568-7136
Practice Address - Street 1:900 BECKETT WAY
Practice Address - Street 2:
Practice Address - City:TARPON SPGS
Practice Address - State:FL
Practice Address - Zip Code:34689-5709
Practice Address - Country:US
Practice Address - Phone:727-934-0876
Practice Address - Fax:727-545-8783
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9483451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN9483451OtherAPRN