Provider Demographics
NPI:1942830393
Name:WITMER, SHEENA MARIE (APRN-PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:MARIE
Last Name:WITMER
Suffix:
Gender:F
Credentials:APRN-PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 METRO PL N STE 300
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5320
Mailing Address - Country:US
Mailing Address - Phone:855-289-1722
Mailing Address - Fax:
Practice Address - Street 1:525 METRO PL N STE 300
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5320
Practice Address - Country:US
Practice Address - Phone:855-289-1722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH386603163WM0102X, 163WW0101X, 363LW0102X
OH0029049363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Single Specialty
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, AmbulatoryGroup - Single Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0029049OtherCNP
OH2910854Medicaid
104473156OtherNCC ID
OH386603OtherRN