Provider Demographics
NPI:1508309782
Name:GEORGE, SHEEJA (NP)
Entity Type:Individual
Prefix:
First Name:SHEEJA
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12610 WILLOWDALE DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6552
Mailing Address - Country:US
Mailing Address - Phone:661-808-8516
Mailing Address - Fax:
Practice Address - Street 1:12610 WILLOWDALE DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-6552
Practice Address - Country:US
Practice Address - Phone:661-808-8516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005186363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP 95005186OtherCALIFORNIA BOARD OF NURSING
CAF09161185OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS