Shea Lyn Despain, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

206256 Issued in OK

Practice address

16 S Water St
Sapulpa, OK 74066-4232

Phone

(918) 347-9022

NPI assigned

Mar 1, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Divine Health and Wellness, LLC

  • Health Service Clinic/Center
  • Sapulpa, OK
  • NPI 1790528164
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1457050114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 S WATER ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740664232",
            "telephone_number": "405-613-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 S WATER ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740664232",
            "telephone_number": "918-347-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPAIN",
        "first_name": "SHEA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "206256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delicate Dreams Midwifery, LLC
• Janea Dennis
• Jennifer Denton
• Derstine Chiropractic Clinic
• Thomas A Derstine, DC
• Brandi D Detherow, LCSW PROVISIONAL
• Aida Araceli Dicken
• Anthony Diskin, DDS
• Divine Health and Wellness, LLC
• Mai Thi DO

• Family Nurse Practitioner in Sapulpa, OK
• Providers in Sapulpa, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.