Provider Demographics
NPI:1396519575
Name:LITTLEJOHN, SHEVONNE
Entity type:Individual
Prefix:MRS
First Name:SHEVONNE
Middle Name:
Last Name:LITTLEJOHN
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 1:4243 GREENLEE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45217-1847
Mailing Address - Country:US
Mailing Address - Phone:513-371-2441
Mailing Address - Fax:
Practice Address - Street 1:2135 HANNAFORD AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-1542
Practice Address - Country:US
Practice Address - Phone:513-371-2441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
OHRQ682657347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No251E00000XAgenciesHome Health