MEDICARE: DEBRA ILENE SHEETS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1942789714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA ILENE SHEETS

Provider Business Mailing Address
First Line	:	64 W NORTH ST APT C
Second Line	:
City	:	MOUNT GILEAD
State	:	OH
Zip	:	43338-1293
Country	:	US
Telephone Number	:	419-560-6373
Fax Number	:	419-751-7336

Provider Business Practice Location Address
First Line	:	64 W NORTH ST APT C
Second Line	:
City	:	MOUNT GILEAD
State	:	OH
Zip	:	43338-1293
Country	:	US
Telephone Number	:	419-560-6373
Fax Number	:	419-751-7336

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2018
Last Update Date	:	08/12/2018

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Directions to “ DEBRA ILENE SHEETS ” Practice Location

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