Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nwse: Nicole Warner Shaha Enterprises, LLC

Organization Surgical Physician Assistant · NPI 1205663846

Nwse: Nicole Warner Shaha Enterprises, LLC is a Surgical Physician Assistant in Mesa, Arizona. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2545 E Intrepid Ave
Mesa, AZ 85204-7028
Phone: (208) 716-2350
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1205663846
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nicole Shaha — Surgical Assistant · (208) 716-2350
NPI enumeratedSeptember 17, 2024
Last updated in NPPESSeptember 17, 2024
Certification dateSeptember 17, 2024
Mailing address2545 E Intrepid Ave, Mesa, AZ 85204-7028

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