Provider Demographics
NPI:1316984446
Name:SHEAHAN, CAROL M (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:SHEAHAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8406 TALLY HO RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4724
Mailing Address - Country:US
Mailing Address - Phone:410-821-5665
Mailing Address - Fax:410-821-7007
Practice Address - Street 1:JOHNS HOPKINS OUTPATIENT CENTER PREOP EVALUATION
Practice Address - Street 2:601 N. CAROLINE ST. JHOC B169
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:410-955-9401
Practice Address - Fax:410-614-8204
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR091503363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner