Provider Demographics
NPI:1326840091
Name:ADDISON, SHEILA LOUISE
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:LOUISE
Last Name:ADDISON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SHADOWBROOK TRCE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-7748
Mailing Address - Country:US
Mailing Address - Phone:404-578-2884
Mailing Address - Fax:
Practice Address - Street 1:90 SHADOWBROOK TRCE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-7748
Practice Address - Country:US
Practice Address - Phone:404-578-2884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health