Provider Demographics
NPI:1871113043
Name:NCUBE, SHEILLAH
Entity type:Individual
Prefix:
First Name:SHEILLAH
Middle Name:
Last Name:NCUBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHEILLAH
Other - Middle Name:
Other - Last Name:NCUBE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RELEVANT CARE HHA
Mailing Address - Street 1:433 LAKE HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:LAKE DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75065-3711
Mailing Address - Country:US
Mailing Address - Phone:253-455-2420
Mailing Address - Fax:
Practice Address - Street 1:433 LAKE HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:LAKE DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75065-3711
Practice Address - Country:US
Practice Address - Phone:253-455-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX850746345Medicaid