Provider Demographics
NPI:1144652389
Name:FLEEGE, SHEILA DUPUIS (NP)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:DUPUIS
Last Name:FLEEGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:ANN
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1590 CARSON RD
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-4903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1590 CARSON RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-4903
Practice Address - Country:US
Practice Address - Phone:530-642-8409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22968363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner