Provider Demographics
NPI:1770658254
Name:SHEA, JULIE B (MS, NP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:B
Last Name:SHEA
Suffix:
Gender:F
Credentials:MS, NP
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Mailing Address - Street 1:75 FRANCIS STREET
Mailing Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL, CARDIOVASCULAR DIVISION
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-6957
Mailing Address - Fax:617-264-5233
Practice Address - Street 1:75 FRANCIS STREET
Practice Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL, CARDIOVASCULAR DIVISION
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-6957
Practice Address - Fax:617-264-5233
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA154799NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0383121Medicaid
MANP3385Medicare ID - Type Unspecified
MA0383121Medicaid