Healthcare Provider Details

I. General information

NPI: 1932725363
Provider Name (Legal Business Name): SHENEKA MCGEE FEARS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2020
Last Update Date: 02/22/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3659 GREEN RD STE 322
BEACHWOOD OH
44122-5715
US

IV. Provider business mailing address

154 E AURORA RD # 204
NORTHFIELD OH
44067-2053
US

V. Phone/Fax

Practice location:
  • Phone: 216-273-4003
  • Fax:
Mailing address:
  • Phone: 216-273-4003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0027300
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.306863
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: