Healthcare Provider Details

I. General information

NPI: 1104637834
Provider Name (Legal Business Name): SHEILA LYNN RONAN-HAWES AGPCNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS SHEILA LYNN HOBDY

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 BRIARFIELD BLVD STE 300
MAUMEE OH
43537-8916
US

IV. Provider business mailing address

801 ROSEHILL RD
JACKSON MI
49202-1762
US

V. Phone/Fax

Practice location:
  • Phone: 419-452-2140
  • Fax: 419-873-6327
Mailing address:
  • Phone: 517-212-2008
  • Fax: 517-212-9023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704245810
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: