Jennifer Michelle Shively, NP - Nurse Practitioner in Orange, CA

Jennifer Michelle Shively, NP is a Nurse Practitioner - Pediatrics, Critical Care based in Orange, California. Jennifer Michelle Shively is licensed to practice in California (license number 20141) and her current practice location is 455 S Main St, Orange, California. She can be reached at her office (for appointments etc.) via phone at (714) 204-3277.

NPI number for Jennifer Michelle Shively is 1003165267 and her current mailing address is 455 S Main St, Orange, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1003165267.

Contact Information

Jennifer Michelle Shively, NP
455 S Main St,
Orange, CA 92868-3835
(714) 204-3277
Not Available



Provider's Profile

Full NameJennifer Michelle Shively
GenderFemale
SpecialityNurse Practitioner - Pediatrics, Critical Care
Location455 S Main St, Orange, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1003165267
  • Provider Enumeration Date: 09/04/2012
  • Last Update Date: 09/04/2012

Medical Identifiers

Medical identifiers for Jennifer Michelle Shively such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003165267NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0222XNurse Practitioner - Pediatrics, Critical Care 20141 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jennifer Michelle Shively is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jennifer Michelle Shively, NP
455 S Main St,
Orange, CA 92868-3835

Ph: (714) 204-3277
Jennifer Michelle Shively, NP
455 S Main St,
Orange, CA 92868-3835

Ph: (714) 204-3277

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