Provider Demographics
NPI:1942789714
Name:SHEETS, DEBRA ILENE
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ILENE
Last Name:SHEETS
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 1:64 W NORTH ST APT C
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-1293
Mailing Address - Country:US
Mailing Address - Phone:419-560-6373
Mailing Address - Fax:419-751-7336
Practice Address - Street 1:64 W NORTH ST APT C
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-1293
Practice Address - Country:US
Practice Address - Phone:419-560-6373
Practice Address - Fax:419-751-7336
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-12
Last Update Date:2018-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty