Provider Demographics
NPI:1669064143
Name:MYLES CLANTON, SHEILA DIANE (HHA)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:DIANE
Last Name:MYLES CLANTON
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 ORCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-1049
Mailing Address - Country:US
Mailing Address - Phone:317-937-0143
Mailing Address - Fax:
Practice Address - Street 1:3636 ORCHARD AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-1049
Practice Address - Country:US
Practice Address - Phone:317-937-0143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health