MEDICARE: ELIZABETH A SHEEHAN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	202C00000X	Independent Medical Examiner Physician	280618	TN

General Provider Information

NPI Number	:	1598599144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH A SHEEHAN RN

Provider Business Mailing Address
First Line	:	2170 SAMS CREEK RD
Second Line	:
City	:	PEGRAM
State	:	TN
Zip	:	37143-5042
Country	:	US
Telephone Number	:	615-887-3123
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 E MAIN ST STE 100
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27701-4074
Country	:	US
Telephone Number	:	615-887-3123
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2024
Last Update Date	:	08/27/2024

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