Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 1174 | AZ |
NPI | 1548311095 |
---|---|
Provider Name | Ms. Pamela Ann Sheean |
First Address | Sierra Vista, AZ 85635-1110 |
Second Address | Sierra Vista, AZ 85635-1110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
476847 | (05) | AZ |