=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891373676
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LANA SHEATS REGISTERED NURSE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/01/2021
-----------------------------------------------------
Last Update Date | 06/16/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 112 MORRISON ST
-----------------------------------------------------
City | WATKINSVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30677-2762
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-248-8307
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 112 MORRISON ST
-----------------------------------------------------
City | WATKINSVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30677-2762
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251F00000X
-----------------------------------------------------
Taxonomy Name | Home Infusion Agency
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 311500000X
-----------------------------------------------------
Taxonomy Name | Alzheimer Center (Dementia Center)
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
Taxonomy Code | 311Z00000X
-----------------------------------------------------
Taxonomy Name | Custodial Care Facility
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #9
-----------------------------------------------------
Taxonomy Code | 163WC2100X
-----------------------------------------------------
Taxonomy Name | Continence Care Registered Nurse
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #10
-----------------------------------------------------
Taxonomy Code | 163WH0500X
-----------------------------------------------------
Taxonomy Name | Hemodialysis Registered Nurse
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #11
-----------------------------------------------------
Taxonomy Code | 163WP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Registered Nurse
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #12
-----------------------------------------------------
Taxonomy Code | 163WP0809X
-----------------------------------------------------
Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #13
-----------------------------------------------------
Taxonomy Code | 163WP2201X
-----------------------------------------------------
Taxonomy Name | Ambulatory Care Registered Nurse
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #14
-----------------------------------------------------
Taxonomy Code | 163WW0000X
-----------------------------------------------------
Taxonomy Name | Wound Care Registered Nurse
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #15
-----------------------------------------------------
Taxonomy Code | 163WX1500X
-----------------------------------------------------
Taxonomy Name | Ostomy Care Registered Nurse
-----------------------------------------------------
License Number | RN241799
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------