Provider Demographics
NPI:1942391750
Name:O'SHEA, KEVIN PATRICK (CRNP)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:PATRICK
Last Name:O'SHEA
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Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:500 YORK RD STE 201
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2872
Practice Address - Country:US
Practice Address - Phone:215-517-1212
Practice Address - Fax:215-517-1229
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2025-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP009030363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health