Healthcare Provider Details

I. General information

NPI: 1912845280
Provider Name (Legal Business Name): SIDNEY ELYSE SHEBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67010 MANITEE DR
SAINT CLAIRSVILLE OH
43950-9402
US

IV. Provider business mailing address

67010 MANITEE DR
SAINT CLAIRSVILLE OH
43950-9402
US

V. Phone/Fax

Practice location:
  • Phone: 740-359-8192
  • Fax:
Mailing address:
  • Phone: 740-359-8192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberVN590830
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberVN590830
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberVN590830
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: