Provider Demographics
NPI:1215614193
Name:PRESIDENT, SHEILA
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:
Last Name:PRESIDENT
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 1:1517 PAINE ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-3253
Mailing Address - Country:US
Mailing Address - Phone:440-787-0445
Mailing Address - Fax:
Practice Address - Street 1:1517 PAINE ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-3253
Practice Address - Country:US
Practice Address - Phone:440-787-0445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH367840321190E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide