Provider Demographics
NPI:1417176926
Name:VAN BUREN, SHAWN SHEEHY (ARNP)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:SHEEHY
Last Name:VAN BUREN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:COLLEEN
Other - Last Name:VAN BUREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:737 CAPE CORAL PKWY E
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-8551
Mailing Address - Country:US
Mailing Address - Phone:305-799-5379
Mailing Address - Fax:
Practice Address - Street 1:737 CAPE CORAL PKWY E
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-8551
Practice Address - Country:US
Practice Address - Phone:239-542-0512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1813602363LF0000X
FLARNP 1813602363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 1813602OtherMEDICAL LICENSE