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General NPI Number Information
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NPI Number | 1568448793
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Entity Type | Individual
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Provider Name | KRISTINA M SHEEHAN MA
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Gender | Female
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 10021 DUPONT CIRCLE CT
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City | FORT WAYNE
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State | IN
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Zip | 46825-1604
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Country | US
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Telephone | 260-426-8117
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Fax | 260-420-0817
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Provider Business Mailing Address
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Address Line | 9604 COLDWATER RD SUITE 109
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City | FORT WAYNE
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State | IN
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Zip | 46825-2096
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Country | US
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Telephone | 260-479-7844
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Fax | 260-444-3656
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 23002234A
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License Number State | IN
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