Provider Demographics
NPI:1376220319
Name:BLUESHIELD, SHEILA M
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:M
Last Name:BLUESHIELD
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:SPIRIT LAKE RECOVERY & WELLNESS
Mailing Address - Street 2:7527 EPHRIAM HILL RD
Mailing Address - City:FORT TOTTEN
Mailing Address - State:ND
Mailing Address - Zip Code:58335
Mailing Address - Country:US
Mailing Address - Phone:701-766-4285
Mailing Address - Fax:
Practice Address - Street 1:SPIRIT LAKE RECOVERY & WELLNESS
Practice Address - Street 2:7527 EPHRIAM HILL RD
Practice Address - City:FORT TOTTEN
Practice Address - State:ND
Practice Address - Zip Code:58335
Practice Address - Country:US
Practice Address - Phone:701-766-4285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist