Provider Demographics
NPI:1699463141
Name:DULANEY, SHAUNA NICHOLE
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:NICHOLE
Last Name:DULANEY
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 1:1603 MULGA RD
Mailing Address - Street 2:
Mailing Address - City:WELLSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45692-9795
Mailing Address - Country:US
Mailing Address - Phone:740-978-8463
Mailing Address - Fax:
Practice Address - Street 1:1603 MULGA RD
Practice Address - Street 2:
Practice Address - City:WELLSTON
Practice Address - State:OH
Practice Address - Zip Code:45692-9795
Practice Address - Country:US
Practice Address - Phone:740-978-8463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide