Provider Demographics
NPI:1902133895
Name:SHEA, CAREY ANN (RN MSN ANP BC)
Entity Type:Individual
Prefix:MS
First Name:CAREY
Middle Name:ANN
Last Name:SHEA
Suffix:
Gender:F
Credentials:RN MSN ANP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 FLUSHING RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-4730
Mailing Address - Country:US
Mailing Address - Phone:810-235-8532
Mailing Address - Fax:810-235-8203
Practice Address - Street 1:1201 FLUSHING RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-4730
Practice Address - Country:US
Practice Address - Phone:810-235-8532
Practice Address - Fax:810-235-8203
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704191260363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty