Provider Demographics
NPI:1306557889
Name:HARVEY, SHAWNTEL
Entity type:Individual
Prefix:
First Name:SHAWNTEL
Middle Name:
Last Name:HARVEY
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 1:1545 HOLLYWOOD ST NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-4155
Mailing Address - Country:US
Mailing Address - Phone:234-223-3481
Mailing Address - Fax:
Practice Address - Street 1:1545 HOLLYWOOD ST NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-4155
Practice Address - Country:US
Practice Address - Phone:234-223-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker