Provider Demographics
NPI:1083990964
Name:SHEARN, AUBREY RAE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:AUBREY
Middle Name:RAE
Last Name:SHEARN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:AUBREY
Other - Middle Name:RAE
Other - Last Name:WADDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26908 DETROIT RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2398
Mailing Address - Country:US
Mailing Address - Phone:440-617-1823
Mailing Address - Fax:440-617-0884
Practice Address - Street 1:2535 HALE ST
Practice Address - Street 2:SUITE A
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1856
Practice Address - Country:US
Practice Address - Phone:440-934-8810
Practice Address - Fax:440-934-8811
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12734-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0057161Medicaid
OH000000737706OtherANTHEM
OH000000737706OtherANTHEM