Provider Demographics
NPI:1427125020
Name:MAXWELL, SHEILA ELAINE (APN-CNP, CNM)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:ELAINE
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:APN-CNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:MAHOMET
Mailing Address - State:IL
Mailing Address - Zip Code:61853-9314
Mailing Address - Country:US
Mailing Address - Phone:217-586-5482
Mailing Address - Fax:
Practice Address - Street 1:1109 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-4703
Practice Address - Country:US
Practice Address - Phone:217-244-5676
Practice Address - Fax:217-244-3519
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health