Provider Demographics
NPI:1902151392
Name:HOLBERT, SHEILA REGINA (RN)
Entity Type:Individual
Prefix:MISS
First Name:SHEILA
Middle Name:REGINA
Last Name:HOLBERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 OAKLAND AVE
Mailing Address - Street 2:APT 4
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3465
Mailing Address - Country:US
Mailing Address - Phone:862-596-8182
Mailing Address - Fax:
Practice Address - Street 1:47 OAKLAND AVE
Practice Address - Street 2:APT 4
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3465
Practice Address - Country:US
Practice Address - Phone:862-596-8182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-21
Last Update Date:2012-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13836600163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation