MEDICARE: DR. CARRIE SHEETS AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	23002368A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000531629	OTHER	IN	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891758793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARRIE SHEETS AU.D.

Provider Business Mailing Address
First Line	:	217 HOLIDAY DR
Second Line	:
City	:	GREENTOWN
State	:	IN
Zip	:	46936-1630
Country	:	US
Telephone Number	:	765-628-3235
Fax Number	:	765-628-3179

Provider Business Practice Location Address
First Line	:	217 HOLIDAY DR
Second Line	:
City	:	GREENTOWN
State	:	IN
Zip	:	46936-1630
Country	:	US
Telephone Number	:	765-628-3235
Fax Number	:	765-628-3179

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	05/14/2008

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