Provider Demographics
NPI:1861497406
Name:BARNGROVER, SHEILA K (ARNP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:K
Last Name:BARNGROVER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:K
Other - Last Name:GRAYBEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1351 KIMBERLY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4194
Mailing Address - Country:US
Mailing Address - Phone:563-355-7733
Mailing Address - Fax:563-355-9077
Practice Address - Street 1:1351 KIMBERLY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4194
Practice Address - Country:US
Practice Address - Phone:563-355-7733
Practice Address - Fax:563-355-9077
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209003266363L00000X
IAA099814363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL500019247OtherRAILROAD MEDICARE
IL779630Medicare PIN
ILS79006Medicare UPIN