Provider Demographics
NPI:1982916599
Name:SHEELEY, FAITH JOY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:JOY
Last Name:SHEELEY
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 1:70 KUKUK LN
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-6943
Mailing Address - Country:US
Mailing Address - Phone:845-336-2616
Mailing Address - Fax:845-336-3302
Practice Address - Street 1:4 YANKEE PL
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428-1510
Practice Address - Country:US
Practice Address - Phone:845-647-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237999-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse