Provider Demographics
NPI:1952688731
Name:SHINN, ELENA MARIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:MARIA
Last Name:SHINN
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:3377 RIVERBEND DRIVE
Mailing Address - Street 2:PEACEHEALTH HOSPITAL MEDICINE
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-8803
Mailing Address - Country:US
Mailing Address - Phone:541-222-6389
Mailing Address - Fax:541-222-6385
Practice Address - Street 1:3377 RIVERBEND DRIVE
Practice Address - Street 2:PEACEHEALTH HOSPITAL MEDICINE
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8803
Practice Address - Country:US
Practice Address - Phone:541-222-6389
Practice Address - Fax:541-222-6385
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP 9285104363L00000X
OR201502909NP-PP208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR00688768Medicaid