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Individual

MS. STACIA N SHEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1100 JOHNSON FERRY RD, SUITE 600, ATLANTA, GA 30342-1709
(404) 256-4777
(404) 256-5515
Mailing address
1835 SAVOY DR, SUITE 300, ATLANTA, GA 30341-1072
(678) 288-9555
(678) 288-9556

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005298
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
558666655I
GA
Enumeration date
02/28/2007
Last updated
08/25/2020
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