Provider Demographics
NPI:1083595375
Name:BEARFIELD, SHANNON A
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:A
Last Name:BEARFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 BELGREEN CT
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-3210
Mailing Address - Country:US
Mailing Address - Phone:804-625-2306
Mailing Address - Fax:
Practice Address - Street 1:6105 BELGREEN CT
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-3210
Practice Address - Country:US
Practice Address - Phone:804-625-2306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)