Provider Demographics
NPI:1467837393
Name:O'HARA, SHAWN CLAIRE
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:CLAIRE
Last Name:O'HARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34905 N 27TH LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-6666
Mailing Address - Country:US
Mailing Address - Phone:928-607-0548
Mailing Address - Fax:
Practice Address - Street 1:34905 N 27TH LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-6666
Practice Address - Country:US
Practice Address - Phone:928-607-0548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN160969163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant