Provider Demographics
NPI:1437843927
Name:SHEETZ, REBECCA EILEEN
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:EILEEN
Last Name:SHEETZ
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:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:REEDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17084-0424
Mailing Address - Country:US
Mailing Address - Phone:717-437-4611
Mailing Address - Fax:
Practice Address - Street 1:2581 CLYDE AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7508
Practice Address - Country:US
Practice Address - Phone:814-867-5415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN676297163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse