Provider Demographics
NPI:1518985092
Name:SHEA, MARGARET E (PNP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:E
Last Name:SHEA
Suffix:
Gender:F
Credentials:PNP
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Mailing Address - Street 1:1 CHILDRENS PL
Mailing Address - Street 2:C B 8116
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-6043
Mailing Address - Fax:314-454-4283
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6043
Practice Address - Fax:314-454-4283
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO122907363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO103810105Medicaid
MO103810105Medicaid
MO103810105Medicaid
MOP00103790Medicare PIN