MEDICARE: SHEA HARMS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	299286	AZ

General Provider Information

NPI Number	:	1336096809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEA HARMS RN

Provider Business Mailing Address
First Line	:	6900 E PRINCESS DR UNIT 1205
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85054-4110
Country	:	US
Telephone Number	:	248-891-8792
Fax Number	:

Provider Business Practice Location Address
First Line	:	6900 E PRINCESS DR UNIT 1205
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85054-4110
Country	:	US
Telephone Number	:	248-891-8792
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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