Provider Demographics
NPI:1407285273
Name:SHEEHAN, URSULA MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:URSULA
Middle Name:MARIE
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CHESTERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4319
Mailing Address - Country:US
Mailing Address - Phone:856-566-2126
Mailing Address - Fax:
Practice Address - Street 1:1500 CONCORD TER FL 5
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2815
Practice Address - Country:US
Practice Address - Phone:954-384-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR10860700367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered