Provider Demographics
NPI:1356315931
Name:MOREHEAD, SHEILA (CFNP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:MOREHEAD
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1409
Mailing Address - Street 2:30 RIDGEWAY COURT
Mailing Address - City:NORRIS
Mailing Address - State:TN
Mailing Address - Zip Code:37828-1409
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 INDEPENDENCE LN
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-3031
Practice Address - Country:US
Practice Address - Phone:423-562-1705
Practice Address - Fax:423-566-3718
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005496363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3649460Medicaid
TN3649460Medicare ID - Type UnspecifiedMEDICARE
TN1356315931Medicare ID - Type Unspecified
TN3649460Medicaid