Provider Demographics
NPI:1609634088
Name:LARKIN, SHEA ALLISON
Entity Type:Individual
Prefix:
First Name:SHEA
Middle Name:ALLISON
Last Name:LARKIN
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 1:1217 MONROE DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3501
Mailing Address - Country:US
Mailing Address - Phone:515-339-0119
Mailing Address - Fax:
Practice Address - Street 1:3600 30TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5753
Practice Address - Country:US
Practice Address - Phone:515-699-5999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA154677163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitationGroup - Multi-Specialty