Provider Demographics
NPI:1780844670
Name:TAIT, SHEILA J (RN)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:J
Last Name:TAIT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:SHEILA
Other - Middle Name:J
Other - Last Name:BREWER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PN-127114
Mailing Address - Street 1:2797 CALEDONIA ASHLEY RD
Mailing Address - Street 2:
Mailing Address - City:CARDINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43315-9406
Mailing Address - Country:US
Mailing Address - Phone:740-244-3524
Mailing Address - Fax:
Practice Address - Street 1:2797 CALEDONIA ASHLEY RD
Practice Address - Street 2:
Practice Address - City:CARDINGTON
Practice Address - State:OH
Practice Address - Zip Code:43315-9406
Practice Address - Country:US
Practice Address - Phone:740-244-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-127114164W00000X
OHRN 35058163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse