| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CAROLINE MARY SHEA | 1629809736 | 2024-08-10 |
Caroline Mary Shea is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1629809736. Registration indicates Caroline Mary Shea is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Caroline Mary Shea |
| Practice Office Address | 502 MADISON OAK DR STE 310 SAN ANTONIO, TX US |
| Practice Office Telephone | 2104838883 |
| Mailing Address | 8931 SCENIC CRK CONVERSE, TX 781091682 US |
| Business Telephone | 3035148331 |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 1171095
TX |
| 193400000X SING | Group Code |