Healthcare Provider Details

I. General information

NPI: 1508719188
Provider Name (Legal Business Name): SHAMIKA MORELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 GORETTI DR
CAMPBELL OH
44405-1906
US

IV. Provider business mailing address

86 GORETTI DR
CAMPBELL OH
44405-1906
US

V. Phone/Fax

Practice location:
  • Phone: 330-518-4798
  • Fax:
Mailing address:
  • Phone: 330-518-4798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: