Provider Demographics
NPI:1134819600
Name:SHEEHAN, SHELBY ANNIS (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:ANNIS
Last Name:SHEEHAN
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 PAINE CIR SE
Mailing Address - Street 2:OFC 603
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50035-1449
Mailing Address - Country:US
Mailing Address - Phone:515-639-0554
Mailing Address - Fax:
Practice Address - Street 1:88 PAINE CIR SE
Practice Address - Street 2:OFC 603
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50035-1449
Practice Address - Country:US
Practice Address - Phone:515-639-0554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG174195363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health