Provider Demographics
NPI:1316820798
Name:WHITE, SHERETTA M
Entity type:Individual
Prefix:
First Name:SHERETTA
Middle Name:M
Last Name:WHITE
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 1:8890 LEVI CT
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-8769
Mailing Address - Country:US
Mailing Address - Phone:216-254-0503
Mailing Address - Fax:216-254-0503
Practice Address - Street 1:8890 LEVI CT
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-8769
Practice Address - Country:US
Practice Address - Phone:216-254-0503
Practice Address - Fax:216-254-0503
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH169353164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse