Provider Demographics
NPI:1710799127
Name:SHEELEY, SAMERRA
Entity type:Individual
Prefix:
First Name:SAMERRA
Middle Name:
Last Name:SHEELEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 PUBLIC SQ APT 524
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-2229
Mailing Address - Country:US
Mailing Address - Phone:234-817-3000
Mailing Address - Fax:
Practice Address - Street 1:1801 SUPERIOR AVE E STE 400
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2135
Practice Address - Country:US
Practice Address - Phone:216-357-2621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker