# JENNIFER ANNE SHEALY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1285426361
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 10045481 | OR | — |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | 201508365RN | OR | — |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | 95035588 | CA | — |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | 95334819 | CA | — |
| 208D00000X | General Practice Physician | 95334819 | CA | — |
| 363LP2300X | Primary Care Nurse Practitioner | 10045481 | OR | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | 95035588 | CA | — |

## Other

- **Enumeration date:** 05/22/2025
- **Last updated:** 05/05/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10045481 | OREGON NURSE PRACTITIONER LICENSE | OR |
| 01 | — | 15295 | NURSE PRACTITIONER PRESCRIPTIVE AUTHORITY NUMBER | OR |
| 01 | — | 95035588 | CALIFORNIA FURNISHING LICENSE | CA |