Provider Demographics
NPI:1316141559
Name:SHEETS, DEBBIE ANN (MS, RN, LICSW, CEAP)
Entity type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:ANN
Last Name:SHEETS
Suffix:
Gender:F
Credentials:MS, RN, LICSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 GILMORE AVE
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-2488
Mailing Address - Country:US
Mailing Address - Phone:612-803-4025
Mailing Address - Fax:
Practice Address - Street 1:53 E 3RD ST STE 201
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-3482
Practice Address - Country:US
Practice Address - Phone:507-454-5479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN65651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN367G2WEOtherBLUE CROSS BLUE SHIELD #
MN366G2SHOtherBLUE CROSS BLUE SHIELD #