Provider Demographics
NPI:1174241269
Name:SHERIDAN, EMILY ELAINE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ELAINE
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 LILLY LN
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-2514
Mailing Address - Country:US
Mailing Address - Phone:865-680-8797
Mailing Address - Fax:
Practice Address - Street 1:107 LILLY LN
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-2514
Practice Address - Country:US
Practice Address - Phone:865-680-8797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula