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General NPI Number Information
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NPI Number | 1083811194
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Entity Type | Individual
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Provider Name | IVY LEE SHEEHAN RD, CDE
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Gender | Female
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 2195 HARRODSBURG RD STE 125
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City | LEXINGTON
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State | KY
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Zip | 40504-3543
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Country | US
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Telephone | 859-323-2232
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Fax | 859-257-1078
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Provider Business Mailing Address
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Address Line | PO BOX 863407
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City | ORLANDO
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State | FL
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Zip | 32886-3407
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Country | US
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Telephone | 941-917-3270
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Fax | 941-917-3275
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | ND9738
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 294093
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 123169
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License Number State | KY
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