Provider Demographics
NPI:1396156576
Name:BARKER, SHANEL (LPN)
Entity type:Individual
Prefix:
First Name:SHANEL
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 HUGHEY SQUARE CT
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3690
Mailing Address - Country:US
Mailing Address - Phone:614-989-2758
Mailing Address - Fax:
Practice Address - Street 1:3296 WESTERVILLE RD STE 1069
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3790
Practice Address - Country:US
Practice Address - Phone:614-383-9964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-09
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH372600000X, 376K00000X, 251E00000X, 251J00000X, 253Z00000X
OHPN-154781164W00000X
OHRU724913172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No372600000XNursing Service Related ProvidersAdult Companion
No376K00000XNursing Service Related ProvidersNurse's Aide
No172A00000XOther Service ProvidersDriver
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care