1093029035 NPI number — CINDY STUART SHEA ANP-BC

Table of content: CINDY STUART SHEA ANP-BC (NPI 1093029035)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093029035 NPI number — CINDY STUART SHEA ANP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHEA
Provider First Name:
CINDY
Provider Middle Name:
STUART
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ANP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHEA
Provider Other First Name:
CINDY
Provider Other Middle Name:
STUART
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1093029035
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SHANDS AT UNIVERSITY OF FLORIDA
Provider Second Line Business Mailing Address:
1600 SW ARCHER RD
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32610-0223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-265-8940
Provider Business Mailing Address Fax Number:
352-265-8970

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SHANDS AT UNIVERSITY OF FLORIDA
Provider Second Line Business Practice Location Address:
1600 SW ARCHER RD
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32610-0223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-265-8940
Provider Business Practice Location Address Fax Number:
352-265-8970
Provider Enumeration Date:
08/02/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  ARNP1435752 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)