Individual
JENNIFER SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
7700 WASHINGTON VILLAGE DR, STE 230, DAYTON, OH 45459-4094
(937) 376-2571
(937) 376-2930
Mailing address
7700 WASHINGTON VILLAGE DR, STE 230, DAYTON, OH 45459-4094
(937) 376-2571
(937) 376-2930
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
785
AK
363LA2200X
Adult Health Nurse Practitioner
Primary
NP-10736
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02D0640596
CLIA#
AK
05
—
NP9648
—
AK
Enumeration date
11/16/2006
Last updated
04/12/2018
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