Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 01070437A | IN |
NPI | 1144464355 |
---|---|
Provider Name | Breann Mackenzie Sheehan |
First Address | Indianapolis, IN 46268-3129 |
Second Address | Indianapolis, IN 46260-2479 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2009 |
Last Update Date | 24/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201098380 | (05) | IN |