Bring a large pot of water to a boil. Add kosher salt generously. Cook fettuccine until al dente per package directions. Reserve 1/2 cup pasta water before draining.

Pat shrimp completely dry with paper towels. Toss with olive oil, garlic powder, paprika, salt, and black pepper.

Heat a large skillet over medium-high heat. Cook shrimp in a single layer for 1 to 2 minutes per side until pink and curled. Remove from pan and set aside.

Reduce heat to medium. Melt butter in the same skillet. Add minced garlic and cook for 60 seconds until fragrant, stirring constantly.

Pour in heavy cream slowly while stirring. Bring to a gentle simmer and cook for 3 to 4 minutes until slightly thickened.

Remove pan from heat or reduce to low. Add parmesan gradually, stirring between each addition until smooth. Add black pepper and nutmeg.

Add drained fettuccine to the sauce and toss to coat. Add reserved pasta water a splash at a time if sauce is too thick.

Return shrimp to the pan. Toss gently to combine. Taste and adjust salt. Top with fresh parsley and extra parmesan. Serve immediately.