Provider Demographics
NPI:1093529505
Name:TUNSTALL, SHAWNA KAYE
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:KAYE
Last Name:TUNSTALL
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 1:11900 DUFF RD LOT 7
Mailing Address - Street 2:
Mailing Address - City:LAKEVIEW
Mailing Address - State:OH
Mailing Address - Zip Code:43331-9386
Mailing Address - Country:US
Mailing Address - Phone:559-545-3590
Mailing Address - Fax:
Practice Address - Street 1:11900 DUFF RD LOT 7
Practice Address - Street 2:
Practice Address - City:LAKEVIEW
Practice Address - State:OH
Practice Address - Zip Code:43331-9386
Practice Address - Country:US
Practice Address - Phone:559-545-3590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide