Provider Demographics
NPI:1821529330
Name:SHELDRAKE, AMY KIMBERLY SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:KIMBERLY SUSAN
Last Name:SHELDRAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:800 ROSE ST # MS 101
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-323-6263
Mailing Address - Fax:859-323-1127
Practice Address - Street 1:800 ROSE ST # MS 101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-323-6263
Practice Address - Fax:859-323-1127
Is Sole Proprietor?:No
Enumeration Date:2017-03-26
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYIP1559207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery