Provider Demographics
NPI:1205015336
Name:SHEEDY, HEATHER MARION
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:MARION
Last Name:SHEEDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 466 BOX 3
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96595
Mailing Address - Country:US
Mailing Address - Phone:011246-370-4212
Mailing Address - Fax:
Practice Address - Street 1:PSC 466 BOX 3
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96595
Practice Address - Country:US
Practice Address - Phone:011246-370-4212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman