Provider Demographics
NPI:1053153635
Name:SHEESLEY, FELICIA (DO, MMS)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:SHEESLEY
Suffix:
Gender:F
Credentials:DO, MMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 HAMMOCKS DR APT 208
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-7424
Mailing Address - Country:US
Mailing Address - Phone:814-853-3050
Mailing Address - Fax:
Practice Address - Street 1:5515 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2695
Practice Address - Country:US
Practice Address - Phone:814-853-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT023821208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice