Provider Demographics
NPI:1285738617
Name:WILLEMS, SHEILA MICHELLE (OD)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:MICHELLE
Last Name:WILLEMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:180 MICHAEL CIR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-5476
Mailing Address - Country:US
Mailing Address - Phone:928-776-4049
Mailing Address - Fax:928-772-3972
Practice Address - Street 1:500 HWY 89 NORTH
Practice Address - Street 2:NORTHERN ARIZONA VA HEALTHCARE SYSTEM
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86313
Practice Address - Country:US
Practice Address - Phone:928-445-4860
Practice Address - Fax:928-717-7553
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1001152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist