Provider Demographics
NPI:1053742098
Name:SHEEHAN, MICHELLE (APRN)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 MAIN ST STE 208
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1192
Mailing Address - Country:US
Mailing Address - Phone:413-253-2767
Mailing Address - Fax:413-253-9767
Practice Address - Street 1:3640 MAIN ST STE 208
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1192
Practice Address - Country:US
Practice Address - Phone:413-253-2767
Practice Address - Fax:413-253-9767
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2290040363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily