Provider Demographics
NPI:1336710813
Name:HOUSEHOLDER, SHARI LYNN (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:LYNN
Last Name:HOUSEHOLDER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7022 ABERCORN PL
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8625
Mailing Address - Country:US
Mailing Address - Phone:614-867-0247
Mailing Address - Fax:614-751-6426
Practice Address - Street 1:603 DILEY RD
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9939
Practice Address - Country:US
Practice Address - Phone:614-751-6413
Practice Address - Fax:614-751-6426
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN225322163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse