Provider Demographics
NPI:1811568041
Name:SHEEKS, DEANNA (APRN)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:SHEEKS
Suffix:
Gender:F
Credentials:APRN
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 776347
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6347
Mailing Address - Country:US
Mailing Address - Phone:502-559-9295
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:3 AUDUBON PLAZA DR STE 610
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1362
Practice Address - Country:US
Practice Address - Phone:502-365-8334
Practice Address - Fax:502-636-8269
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015972363LF0000X
IN28215575A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily