Healthcare Provider Details

I. General information

NPI: 1669483327
Provider Name (Legal Business Name): LAURA J SHEELEY APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 KIRMAN AVE
RENO NV
89502-1175
US

IV. Provider business mailing address

5250 NEIL RD #207
RENO NV
89502-6542
US

V. Phone/Fax

Practice location:
  • Phone: 775-322-5050
  • Fax: 775-322-6191
Mailing address:
  • Phone: 775-398-1981
  • Fax: 775-398-1984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPN000663
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: