Healthcare Provider Details

I. General information

NPI: 1902167372
Provider Name (Legal Business Name): KAREN LEE SHEETS BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 HOHMAN AVE
HAMMOND IN
46320-2423
US

IV. Provider business mailing address

8400 LOUISIANA ST
MERRILLVILLE IN
46410-6385
US

V. Phone/Fax

Practice location:
  • Phone: 219-931-0427
  • Fax: 219-937-5808
Mailing address:
  • Phone: 219-757-1928
  • Fax: 219-757-1950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: