Healthcare Provider Details

I. General information

NPI: 1316841943
Provider Name (Legal Business Name): SHEEHAN FNP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 N STOCKTON HILL RD STE 101
KINGMAN AZ
86401-6232
US

IV. Provider business mailing address

1115 N STOCKTON HILL RD STE 101
KINGMAN AZ
86401-6232
US

V. Phone/Fax

Practice location:
  • Phone: 928-263-1481
  • Fax: 928-307-7688
Mailing address:
  • Phone: 928-263-1481
  • Fax: 928-307-7688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANDREA SHEEHAN
Title or Position: OWNER
Credential: FNP
Phone: 928-529-0374