Provider Demographics
NPI:1609943927
Name:SHEHAN-BAKEWELL, COLLEEN MARIE (RNC, MS, NNP)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:MARIE
Last Name:SHEHAN-BAKEWELL
Suffix:
Gender:F
Credentials:RNC, MS, NNP
Other - Prefix:
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Mailing Address - Street 1:6099 N PLACITA FRESNILLO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1257
Mailing Address - Country:US
Mailing Address - Phone:520-529-2370
Mailing Address - Fax:520-324-5585
Practice Address - Street 1:5375 E ERICKSON DR
Practice Address - Street 2:SUITE 103
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2838
Practice Address - Country:US
Practice Address - Phone:520-324-5585
Practice Address - Fax:520-324-1848
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDRN071369363LA2100X
AZAP3768363LF0000X
AZAP6608363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily