Individual
MRS. KATHLEEN SHEARER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
5895 TRINITY PKWY, SUITE 100, CENTREVILLE, VA 20120-1995
(703) 802-2004
(703) 802-2113
Mailing address
5895 TRINITY PKWY, SUITE 100, CENTREVILLE, VA 20120-1995
(703) 802-2004
(703) 802-2113
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0017001302
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017001302
LICENSED AUTHORIZATION TO PRESCRIBE
VA
01
—
0024052576
ADULT NURSE PRACTITIONER
VA
Enumeration date
06/26/2008
Last updated
06/26/2008
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