Individual
TIERNEY ROSE SHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3048 E BASELINE RD STE 120, MESA, AZ 85204-7288
(480) 505-3276
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6813
AZ
363A00000X
Physician Assistant
PA2666
NV
Other
Enumeration date
09/04/2017
Last updated
12/12/2023
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