Provider Demographics
NPI:1932366762
Name:CRUM, SHEILA M
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:M
Last Name:CRUM
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 1:1097 BACON RD NW
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-9305
Mailing Address - Country:US
Mailing Address - Phone:330-627-0866
Mailing Address - Fax:
Practice Address - Street 1:525 CANTON RD NW APT 1B
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-9416
Practice Address - Country:US
Practice Address - Phone:330-771-0218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2343995374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2343995OtherPROVIDER NO.