Provider Demographics
NPI:1972005197
Name:SHELDON, BETH ANN (LPN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:SHELDON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 PALMER HILL RD
Mailing Address - Street 2:
Mailing Address - City:UNADILLA
Mailing Address - State:NY
Mailing Address - Zip Code:13849-2148
Mailing Address - Country:US
Mailing Address - Phone:607-353-2351
Mailing Address - Fax:
Practice Address - Street 1:267 PALMER HILL RD
Practice Address - Street 2:
Practice Address - City:UNADILLA
Practice Address - State:NY
Practice Address - Zip Code:13849-2148
Practice Address - Country:US
Practice Address - Phone:607-353-2351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-03
Last Update Date:2018-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY289310164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse