Doctor Name: | AUTUMN SHEESE |
NPI Number: | 1649459330 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 28145312A |
Business Practice Address: | 1214 E National Ave Ste 100 Brazil, IN - 478342700 |
Business Phone Number: | 8124422820 |
Business Fax Number: | |
Mailing Address: | 8840 Commerce Park Pl Ste E, INDIANAPOLIS |
State: | IN |
Postal Code: | 462683129 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/30/2007 |
NPI Last Update Date: | 02/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 28145312A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |