Shively, Jennifer Michelle

Shively, Jennifer Michelle is an individual health care provider with primary practice located at 455 S Main St , Orange CA 92868-3835. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care, which is considered as her primary health care specialty. Shively, Jennifer Michelle can be contacted via phone (714) 204-3277.

Contact Information

Primary practice address
455 S Main St Orange CA 92868-3835
Phone: (714) 204-3277
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care 363LP0222X 20141 California

Profile Details

NPI number 1003165267
LBN Legal business name Shively, Jennifer Michelle
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 4th, 2012
Last updated Sep 4th, 2012 - about 14 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.

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