Provider Demographics
NPI:1306610159
Name:HEARD, A'SHAWNTAY
Entity type:Individual
Prefix:
First Name:A'SHAWNTAY
Middle Name:
Last Name:HEARD
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 1:412 N ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-1711
Mailing Address - Country:US
Mailing Address - Phone:330-565-1722
Mailing Address - Fax:
Practice Address - Street 1:412 N ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-1711
Practice Address - Country:US
Practice Address - Phone:330-565-1722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker