Provider Demographics
NPI:1578846010
Name:SHEETS, PATRICIA ANN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:ANN
Last Name:SHEETS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:SHEETS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:316 N. TERRACE ST
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548
Mailing Address - Country:US
Mailing Address - Phone:608-314-4558
Mailing Address - Fax:
Practice Address - Street 1:316 N. TERRACE ST.
Practice Address - Street 2:
Practice Address - City:JANBESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548
Practice Address - Country:US
Practice Address - Phone:608-314-4558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI32503164X00000X, 3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider