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General NPI Number Information
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NPI Number | 1922164888
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Entity Type | Organization
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Legal Business Name | SHARON HOUSE LPN
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6970 RAMEY RD
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City | CENTERBURG
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State | OH
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Zip | 43011-9645
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Country | US
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Telephone | 740-625-5490
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Fax |
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Provider Business Mailing Address
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Address Line | 113 MARITA DR
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City | MOUNT VERNON
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State | OH
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Zip | 43050-2911
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Country | US
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Telephone | 740-397-5381
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | SHARON DIANE HOUSE
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Credential | LPN
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Telephone | 740-397-5381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN 071199
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License Number State | OH
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