Provider Demographics
NPI:1669483327
Name:SHEELEY, LAURA J (APN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:J
Last Name:SHEELEY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 NEIL RD
Mailing Address - Street 2:#207
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6542
Mailing Address - Country:US
Mailing Address - Phone:775-398-1981
Mailing Address - Fax:775-398-1984
Practice Address - Street 1:50 KIRMAN AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1175
Practice Address - Country:US
Practice Address - Phone:775-322-5050
Practice Address - Fax:775-322-6191
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN000663363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002416107Medicaid
NV002416107Medicaid
NVV35554Medicare ID - Type Unspecified