Provider Demographics
NPI:1982249942
Name:NOBLES, SHEILA MICHELE
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:MICHELE
Last Name:NOBLES
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 1:5043 CYPRESS LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:31636-3111
Mailing Address - Country:US
Mailing Address - Phone:863-213-9286
Mailing Address - Fax:
Practice Address - Street 1:5043 CYPRESS LAKE DR
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:GA
Practice Address - Zip Code:31636-3111
Practice Address - Country:US
Practice Address - Phone:863-213-9286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor