Provider Demographics
NPI:1831546043
Name:MCPHERSON, SHAWNCEY (PA-C)
Entity type:Individual
Prefix:
First Name:SHAWNCEY
Middle Name:
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 STATE ROUTE 89
Mailing Address - Street 2:
Mailing Address - City:CHINO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86323
Mailing Address - Country:US
Mailing Address - Phone:928-404-1488
Mailing Address - Fax:866-232-8580
Practice Address - Street 1:87 STATE ROUTE 89
Practice Address - Street 2:
Practice Address - City:CHINO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86323
Practice Address - Country:US
Practice Address - Phone:928-404-1488
Practice Address - Fax:866-232-8580
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7384363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant