Provider Demographics
NPI:1285050328
Name:SHELDON, CARRIE ANNE
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:ANNE
Last Name:SHELDON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:ANNE
Other - Last Name:CRUMRINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3110 E BLUELICK RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-1564
Mailing Address - Country:US
Mailing Address - Phone:419-296-5822
Mailing Address - Fax:
Practice Address - Street 1:3110 E BLUELICK RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-1564
Practice Address - Country:US
Practice Address - Phone:419-296-5822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider