Provider Demographics
NPI:1083313761
Name:SHEARER, MISTY (FNP-C)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:SHEARER
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:
Other - Last Name:GRAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:18451 E AUBREY GLEN RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-3626
Mailing Address - Country:US
Mailing Address - Phone:480-332-9729
Mailing Address - Fax:
Practice Address - Street 1:8950 E GERMANN RD STE 15
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-5301
Practice Address - Country:US
Practice Address - Phone:480-477-4467
Practice Address - Fax:888-879-7542
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ289235207Q00000X, 363L00000X, 202D00000X
AZRN151875163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine