Healthcare Provider Details

I. General information

NPI: 1306637202
Provider Name (Legal Business Name): SHARON LYSAGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 WHITE OAK DR
ELYRIA OH
44035-4135
US

IV. Provider business mailing address

375 WHITE OAK DR
ELYRIA OH
44035-4135
US

V. Phone/Fax

Practice location:
  • Phone: 440-755-1777
  • Fax:
Mailing address:
  • Phone: 440-755-1777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: