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Jacob C Shively
Nurse Practitioner in Fort Wayne, Indiana
NPI 1215672928

Jacob C Shively is a Nurse Practitioner based in Oak Brook, IN. Jacob C Shively practices in Fort Wayne, IN. The NPI Number for Jacob C Shively is 1215672928 and holds a License No. 71012742A (Indiana).

The current practice location address for Jacob C Shively is 11104 Parkview Circle Dr Ste 330, Fort Wayne, IN and can be reached out via phone at 260-494-3484 and via fax at 260-969-0188.

Location: 11104 Parkview Circle Dr Ste 330, Fort Wayne, IN, 60523-1563
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215672928
Provider Name
Jacob C Shively
Credential
Provider Entity Type
Individual
Gender
Male
Address
11104 Parkview Circle Dr Ste 330, Fort Wayne, IN, 60523-1563
Phone Number
260-494-3484
Fax Number
260-969-0188
Provider Enumeration Date
04/28/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
11104 Parkview Circle Dr Ste 330
City
Fort Wayne
State
Indiana
Zip
46845-1674
Phone Number
260-494-3484
Fax Number
260-969-0188
person
Provider Business Mailing Address Details
Address
11104 Parkview Circle Dr Ste 330
City
Fort Wayne
State
Indiana
Zip
46845-1674
Phone Number
260-494-3484
Fax Number
260-969-0188
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
71012742A (Indiana)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
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