| Doctor Name: | MS. KRISTEN SHEA |
| NPI Number: | 1285002188 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | R187273 |
| Business Practice Address: | 6095 Marshalee Dr Elkridge, MD - 210756053 |
| Business Phone Number: | 8003077820 |
| Business Fax Number: | |
| Mailing Address: | 111 W Centre St Apt 1906, BALTIMORE |
| State: | MD |
| Postal Code: | 212014679 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/09/2015 |
| NPI Last Update Date: | 09/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | R187273 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |