Provider Demographics
NPI:1548262876
Name:SHEETS, MICHAEL AARON (FNP)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:AARON
Last Name:SHEETS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1030
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:OR
Mailing Address - Zip Code:97633-1030
Mailing Address - Country:US
Mailing Address - Phone:541-798-5074
Mailing Address - Fax:
Practice Address - Street 1:125 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:OR
Practice Address - Zip Code:97633
Practice Address - Country:US
Practice Address - Phone:541-798-5074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR93-006519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000XCDBQMedicare PIN
5164840001Medicare NSC
ORR78319Medicare UPIN