Provider Demographics
NPI:1093144388
Name:BALLINGER, SHEILA (LPN)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:BALLINGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 W CENTER
Mailing Address - Street 2:
Mailing Address - City:WEST MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43358
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:319 W CENTER STREET
Practice Address - Street 2:
Practice Address - City:WEST MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43358
Practice Address - Country:US
Practice Address - Phone:937-355-3054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH077643164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse