Provider Demographics
NPI:1700552221
Name:SHELDON, MICHELLE (MSN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SHELDON
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:SLOAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6834 STATE ROUTE 5
Mailing Address - Street 2:
Mailing Address - City:KINSMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44428-9732
Mailing Address - Country:US
Mailing Address - Phone:330-984-2681
Mailing Address - Fax:
Practice Address - Street 1:6834 STATE ROUTE 5
Practice Address - Street 2:
Practice Address - City:KINSMAN
Practice Address - State:OH
Practice Address - Zip Code:44428-9732
Practice Address - Country:US
Practice Address - Phone:330-984-2681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2020039380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily