Provider Demographics
NPI:1972548923
Name:SHEEHAN, RUTH C (RNFNP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:C
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:RNFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1283
Mailing Address - Country:US
Mailing Address - Phone:585-393-3515
Mailing Address - Fax:585-393-3528
Practice Address - Street 1:495 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1283
Practice Address - Country:US
Practice Address - Phone:585-393-3515
Practice Address - Fax:585-393-3528
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3330031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02154089Medicaid
NYP27681Medicare UPIN
NYCC4763Medicare ID - Type Unspecified