Provider Demographics
NPI:1336570126
Name:WHELAN, SHEILA (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:
Last Name:WHELAN
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 MONROE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2888
Mailing Address - Country:US
Mailing Address - Phone:313-914-5581
Mailing Address - Fax:313-914-5580
Practice Address - Street 1:1331 MONROE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2888
Practice Address - Country:US
Practice Address - Phone:313-914-5581
Practice Address - Fax:313-914-5580
Is Sole Proprietor?:No
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704199843363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health