Provider Demographics
NPI:1023361300
Name:OROZCO, SHELIA M (LPN-M-IV)
Entity Type:Individual
Prefix:MRS
First Name:SHELIA
Middle Name:M
Last Name:OROZCO
Suffix:
Gender:F
Credentials:LPN-M-IV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 MELMORE ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-3531
Mailing Address - Country:US
Mailing Address - Phone:419-443-5658
Mailing Address - Fax:419-443-0365
Practice Address - Street 1:164 MELMORE ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-3531
Practice Address - Country:US
Practice Address - Phone:419-443-5658
Practice Address - Fax:419-443-0365
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.143442-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse