Basic Information
| Provider Information | |||||||||
| NPI: | 1124016928 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | O'SHEA | ||||||||
| FirstName: | NOREEN | ||||||||
| MiddleName: | ELLEN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 UNIVERSITY AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503142355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152481490 | ||||||||
| FaxNumber: | 5152481440 | ||||||||
| Practice Location | |||||||||
| Address1: | 2353 SE 14TH ST | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503201109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152481400 | ||||||||
| FaxNumber: | 5152481414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2005 | ||||||||
| LastUpdateDate: | 05/07/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 2215 | IA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 4034 | SD | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 02215 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.