MEDICARE: MRS. SHEILHA SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	0031947	OH

General Provider Information

NPI Number	:	1861128068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEILHA SMITH

Provider Business Mailing Address
First Line	:	1920 CLEVELAND RD W
Second Line	:
City	:	HURON
State	:	OH
Zip	:	44839-1249
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 CLEVELAND RD W
Second Line	:
City	:	HURON
State	:	OH
Zip	:	44839-1249
Country	:	US
Telephone Number	:	419-433-4990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	10/20/2022

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Directions to “ MRS. SHEILHA SMITH ” Practice Location

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