Healthcare Provider Details

I. General information

NPI: 1346864246
Provider Name (Legal Business Name): SHEETAL CHEPURI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAPTIST HEALTH CORBIN 1 TRILLIUM WAY
CORBIN KY
40701
US

IV. Provider business mailing address

4542 HAMMOCKS DRIVE APT 308
ERIE PA
16506
US

V. Phone/Fax

Practice location:
  • Phone: 859-257-1774
  • Fax:
Mailing address:
  • Phone: 561-335-6769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number323830
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number61660
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: