| Doctor Name: | MRS. JENNIFER LEA MYERS SHOTWELL |
| NPI Number: | 1083796940 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN CPNP |
| License Number: | 270 |
| Business Practice Address: | 64-1032 Mamalahoa Hwy Suite 204 Kamuela, HI - 967438441 |
| Business Phone Number: | 8088876543 |
| Business Fax Number: | 8088876294 |
| Mailing Address: | Po Box 6149, KAMUELA |
| State: | HI |
| Postal Code: | 967436149 |
| Phone Number: | 8088876543 |
| Fax Number: | 8088876294 |
| NPI Enumeration Date: | 10/19/2006 |
| NPI Last Update Date: | 04/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 270 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |