Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 15490 | NV |
N | 111NI0900X | Internist | 15490 | NV |
Y | 207R00000X | Internist | 71635 | MT |
Y | 111NI0900X | Internist | 71635 | MT |
N | 207R00000X | Internist | G80643 | CA |
N | 111NI0900X | Internist | G80643 | CA |
N | 207RH0002X | Hospice and Palliative Medicine | 15490 | NV |
NPI | 1215083845 |
---|---|
Provider Name | Maureen Lee Sheehan |
First Address | Bozeman, MT 59715-6902 |
Second Address | Reno, NV 89519-0910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 26/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11553933 | CAQH (01) |