Individual provider · Type 1 NPI
Jennifer Michelle Shively, N.P.
Critical Care Pediatric Nurse Practitioner · Orange, CA
NPI number
1003165267
Active
Practice location
455 S Main St
Orange, CA 92868-3835
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Critical Care Pediatric Nurse Practitioner Primary | 363LP0222X | 20141 (CA) |
Critical Care Pediatric Nurse Practitioner: Definition to come...
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About NPI 1003165267
Jennifer Michelle Shively, N.P.'s National Provider Identifier is 1003165267, issued on Sep 4, 2012. The primary taxonomy on file is Critical Care Pediatric Nurse Practitioner (363LP0222X), and the practice location is in Orange, CA. The record was last updated on Sep 4, 2012.