Shea, Elena Suzanne
Shea, Elena Suzanne is an individual health care provider with primary practice located at 450 S Willard St Ste 103 , Cottonwood AZ 86326-6744. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Shea, Elena Suzanne can be contacted via phone (928) 634-9573.Contact Information
Primary practice address
450 S Willard St Ste 103
Cottonwood AZ 86326-6744
Phone: (928) 634-9573
Fax: (928) 634-0135
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | J4510 | Texas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 41858 | Arizona |
Profile Details
| NPI number | 1023150794 |
|---|---|
| LBN Legal business name | Shea, Elena Suzanne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 12th, 2007 |
| Last updated | Jan 11th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023150794 | NPPES |
| Arizona | MEDICAID | 136239 |
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