Provider Demographics
NPI:1891758793
Name:SHEETS, CARRIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:
Last Name:SHEETS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:GREENTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46936-1630
Mailing Address - Country:US
Mailing Address - Phone:765-628-3235
Mailing Address - Fax:765-628-3179
Practice Address - Street 1:217 HOLIDAY DR
Practice Address - Street 2:
Practice Address - City:GREENTOWN
Practice Address - State:IN
Practice Address - Zip Code:46936-1630
Practice Address - Country:US
Practice Address - Phone:765-628-3235
Practice Address - Fax:765-628-3179
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002368A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000531629OtherANTHEM
IN200518130Medicaid
IN000000531629OtherANTHEM
INP00433076Medicare PIN