Healthcare Provider Details

I. General information

NPI: 1083114979
Provider Name (Legal Business Name): MARGARET SHEAHAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2018
Last Update Date: 02/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8687 E VIA DE VENTURA STE 110
SCOTTSDALE AZ
85258-3351
US

IV. Provider business mailing address

4153 W PARK AVE
CHANDLER AZ
85226-7237
US

V. Phone/Fax

Practice location:
  • Phone: 480-609-9000
  • Fax: 480-609-9021
Mailing address:
  • Phone: 314-365-1368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN191721
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: