Provider Demographics
NPI:1851469423
Name:PULLEN, SHEILA MARIE (NURSE)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:MARIE
Last Name:PULLEN
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 E UTICA ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2825
Mailing Address - Country:US
Mailing Address - Phone:315-342-9225
Mailing Address - Fax:
Practice Address - Street 1:169 E UTICA ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2825
Practice Address - Country:US
Practice Address - Phone:315-342-9225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15908-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse