MEDICARE: KELLY A SPEARS-SHEA NP

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	363L00000X	Nurse Practitioner	583275	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497703219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY A SPEARS-SHEA NP

Provider Business Mailing Address
First Line	:	4300 CAGLE DR STE 200
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8380
Country	:	US
Telephone Number	:	817-255-1940
Fax Number	:	817-255-1977

Provider Business Practice Location Address
First Line	:	4300 CAGLE DR STE 200
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8380
Country	:	US
Telephone Number	:	817-255-1940
Fax Number	:	817-255-1977

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	01/07/2011

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Directions to “ KELLY A SPEARS-SHEA NP” Practice Location

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