Provider Demographics
NPI:1588874572
Name:BRYANT, SHAMANIQUE RAMIKA (STNA)
Entity type:Individual
Prefix:
First Name:SHAMANIQUE
Middle Name:RAMIKA
Last Name:BRYANT
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 E 143RD ST
Mailing Address - Street 2:
Mailing Address - City:EAST CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-2539
Mailing Address - Country:US
Mailing Address - Phone:216-799-8757
Mailing Address - Fax:
Practice Address - Street 1:1341 E 143RD ST
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-2539
Practice Address - Country:US
Practice Address - Phone:216-799-8757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide