Provider Demographics
NPI:1225048184
Name:SHEELEY, CHARLES A II (MSN, APN)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:A
Last Name:SHEELEY
Suffix:II
Gender:M
Credentials:MSN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10405 CHADWELL DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4206
Mailing Address - Country:US
Mailing Address - Phone:775-852-5769
Mailing Address - Fax:775-322-6191
Practice Address - Street 1:50 KIRMAN AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1175
Practice Address - Country:US
Practice Address - Phone:775-322-5050
Practice Address - Fax:775-322-6191
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN000662363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVS89858Medicare UPIN
NVV102096Medicare ID - Type Unspecified