Provider Demographics
NPI:1285442533
Name:SPEARS, SHALETHA NOEL (CNA)
Entity type:Individual
Prefix:
First Name:SHALETHA
Middle Name:NOEL
Last Name:SPEARS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 AUDREY DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-7269
Mailing Address - Country:US
Mailing Address - Phone:470-535-9498
Mailing Address - Fax:
Practice Address - Street 1:2903 AUDREY DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7269
Practice Address - Country:US
Practice Address - Phone:704-396-6140
Practice Address - Fax:704-396-6141
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN00289015763747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant