Provider Demographics
NPI:1437967833
Name:GARDNER, SHEILA E
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:E
Last Name:GARDNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 SUDBURY RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-5120
Mailing Address - Country:US
Mailing Address - Phone:216-233-7428
Mailing Address - Fax:
Practice Address - Street 1:3737 SUDBURY RD
Practice Address - Street 2:
Practice Address - City:SHAKER HTS
Practice Address - State:OH
Practice Address - Zip Code:44120-5120
Practice Address - Country:US
Practice Address - Phone:216-233-7428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care