Provider Demographics
NPI:1932345535
Name:HENRY, SHEILA LORRAINE (LPN)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:LORRAINE
Last Name:HENRY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 FAIRLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-2620
Mailing Address - Country:US
Mailing Address - Phone:740-344-9649
Mailing Address - Fax:
Practice Address - Street 1:950 FAIRLAWN AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-2620
Practice Address - Country:US
Practice Address - Phone:740-344-9649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN122262IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse