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NPI Code Detail

MEDICARE: KATHY SHEA APN, CFNP

MEDICARE: KATHY SHEA APN, CFNP
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
1363L00000XNurse Practitioner209002514IL
2363LF0000XFamily Nurse Practitioner0024171252VA

General Provider Information

NPI Number : 1699700633
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHY SHEA APN, CFNP
Provider Business Mailing Address
First Line : 263 MCLAWS CIR STE 105
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23185-5674
Country : US
Telephone Number : 757-941-5600
Fax Number : 757-564-0557
Provider Business Practice Location Address
First Line : 263 MCLAWS CIR STE 105
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23185-5674
Country : US
Telephone Number : 757-941-5600
Fax Number : 757-564-0557
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 11/01/2018

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