Provider Demographics
NPI:1508269952
Name:SHEETS, CONSTANCE (DNP, RN, GCNS-BC)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:SHEETS
Suffix:
Gender:F
Credentials:DNP, RN, GCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 LA PORTE AVE LEBIEN HALL ROOM #6
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383
Mailing Address - Country:US
Mailing Address - Phone:218-464-5297
Mailing Address - Fax:
Practice Address - Street 1:9003 W 200 S
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-9503
Practice Address - Country:US
Practice Address - Phone:219-785-4194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28118004A364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology