Provider Demographics
NPI:1972838134
Name:SHEEHEY, DIANE ELLEN (RPH)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:ELLEN
Last Name:SHEEHEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 W NIGHTHAWK WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-9306
Mailing Address - Country:US
Mailing Address - Phone:520-954-6401
Mailing Address - Fax:
Practice Address - Street 1:7870 N SILVERBELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-8230
Practice Address - Country:US
Practice Address - Phone:520-744-7909
Practice Address - Fax:520-744-7841
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS009105183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist