Provider Demographics
NPI:1730332461
Name:CASTER, SHEILA RENE' (LPN)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:RENE'
Last Name:CASTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6080 STATE ROUTE 101 E
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:OH
Mailing Address - Zip Code:43410-9720
Mailing Address - Country:US
Mailing Address - Phone:419-765-0428
Mailing Address - Fax:
Practice Address - Street 1:6080 STATE ROUTE 101 E
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:OH
Practice Address - Zip Code:43410-9720
Practice Address - Country:US
Practice Address - Phone:419-765-0428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-26
Last Update Date:2008-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.126919-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse