Provider Demographics
NPI:1104681550
Name:BLAIR, SHAYLA CHRISTINE
Entity type:Individual
Prefix:
First Name:SHAYLA
Middle Name:CHRISTINE
Last Name:BLAIR
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 1:65 RUTLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-4921
Mailing Address - Country:US
Mailing Address - Phone:330-531-5818
Mailing Address - Fax:
Practice Address - Street 1:65 RUTLEDGE DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-4921
Practice Address - Country:US
Practice Address - Phone:330-531-5818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty