MEDICARE: DR. ASHLEY MARIE SHEA CNP

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	363LP2300X	Primary Care Nurse Practitioner	APRN.CNP.024288	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	APRN.CNP.024288	OTHER	OH	LICENSURE

General Provider Information

NPI Number	:	1013474436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY MARIE SHEA CNP

Provider Business Mailing Address
First Line	:	3908 MIAMI RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-3705
Country	:	US
Telephone Number	:	513-760-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	3908 MIAMI RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-3705
Country	:	US
Telephone Number	:	513-760-5511
Fax Number	:

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

Provider Enumeration Date	:	02/21/2019
Last Update Date	:	06/11/2019

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