Provider Demographics
NPI:1346442514
Name:OLDEHOEFT-OHLEMANN, SHUREE KRISTINE (PA-C)
Entity Type:Individual
Prefix:
First Name:SHUREE
Middle Name:KRISTINE
Last Name:OLDEHOEFT-OHLEMANN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4527 E MARCONI AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4266
Mailing Address - Country:US
Mailing Address - Phone:480-766-0550
Mailing Address - Fax:602-795-2445
Practice Address - Street 1:4527 E MARCONI AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4266
Practice Address - Country:US
Practice Address - Phone:480-766-0550
Practice Address - Fax:602-795-2445
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3164363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant