Provider Demographics
NPI:1518584424
Name:SHAHIN, CARYN LOUISA (PMHNP)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:LOUISA
Last Name:SHAHIN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 W DUBLIN ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3599
Mailing Address - Country:US
Mailing Address - Phone:715-379-6949
Mailing Address - Fax:
Practice Address - Street 1:3227 E BELL RD STE 170
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-8710
Practice Address - Country:US
Practice Address - Phone:602-652-3500
Practice Address - Fax:602-652-3582
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ242534363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health