MEDICARE: MISTY SHEARER FNP-C

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	207Q00000X	Family Medicine Physician	289235	AZ
2	363L00000X	Nurse Practitioner	289235	AZ
3	163WE0003X	Emergency Registered Nurse	RN151875	AZ
4	202D00000X	Integrative Medicine Physician	289235	AZ

General Provider Information

NPI Number	:	1083313761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISTY SHEARER FNP-C

Provider Business Mailing Address
First Line	:	18451 E AUBREY GLEN RD
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-3626
Country	:	US
Telephone Number	:	480-332-9729
Fax Number	:

Provider Business Practice Location Address
First Line	:	8950 E GERMANN RD STE 15
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85212-5301
Country	:	US
Telephone Number	:	480-477-4467
Fax Number	:	888-879-7542

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

Provider Enumeration Date	:	03/01/2023
Last Update Date	:	07/10/2025

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