Provider Demographics
NPI:1831789064
Name:MCSHERY (SHEARS), MICHELLE MARIE (RN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:MCSHERY (SHEARS)
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 STEDMAN ST STE 27
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-2792
Mailing Address - Country:US
Mailing Address - Phone:978-519-9910
Mailing Address - Fax:
Practice Address - Street 1:225 STEDMAN ST STE 27
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-2792
Practice Address - Country:US
Practice Address - Phone:978-519-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN230883163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse