Provider Demographics
NPI:1285266460
Name:O'SHEA, NOREEN (ES, RN)
Entity type:Individual
Prefix:
First Name:NOREEN
Middle Name:
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:ES, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 N CAMILLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-2803
Mailing Address - Country:US
Mailing Address - Phone:520-400-1708
Mailing Address - Fax:
Practice Address - Street 1:3230 N CRAYCROFT RD APT 3
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-5246
Practice Address - Country:US
Practice Address - Phone:520-400-1708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6867260101YM0800X
AZ052057163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health