Healthcare Provider Details

I. General information

NPI: 1811233760
Provider Name (Legal Business Name): SHEA A FIJAL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEA A MARSH NP

II. Dates (important events)

Enumeration Date: 12/21/2012
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 E MEYER BLVD
KANSAS CITY MO
64132-1136
US

IV. Provider business mailing address

PO BOX 749495
ATLANTA GA
30374-9495
US

V. Phone/Fax

Practice location:
  • Phone: 816-974-5050
  • Fax: 816-683-7645
Mailing address:
  • Phone: 855-963-2100
  • Fax: 813-321-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2013006310
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2013006310
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: