Provider Demographics
NPI:1861604985
Name:BOOROM, SHEILA KAY
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:KAY
Last Name:BOOROM
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 1:7300 ST. RT. 314
Mailing Address - Street 2:P. O. BOX 155
Mailing Address - City:SHAUCK
Mailing Address - State:OH
Mailing Address - Zip Code:43349-0155
Mailing Address - Country:US
Mailing Address - Phone:419-362-1074
Mailing Address - Fax:
Practice Address - Street 1:7300 ST. RT. 314
Practice Address - Street 2:
Practice Address - City:SHAUCK
Practice Address - State:OH
Practice Address - Zip Code:43349-0155
Practice Address - Country:US
Practice Address - Phone:419-362-1074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide