Provider Demographics
NPI:1427761337
Name:ROBINSON, SHAVONNE NICOLE
Entity type:Individual
Prefix:
First Name:SHAVONNE
Middle Name:NICOLE
Last Name:ROBINSON
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 1:4261 STANHOPE KELLOGGSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44003-9610
Mailing Address - Country:US
Mailing Address - Phone:234-738-1146
Mailing Address - Fax:
Practice Address - Street 1:4261 STANHOPE KELLOGGSVILLE RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:OH
Practice Address - Zip Code:44003-9610
Practice Address - Country:US
Practice Address - Phone:234-738-1146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No171W00000XOther Service ProvidersContractor
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion