Provider Demographics
NPI:1720818743
Name:SHROPSHIRE, ALEENA
Entity type:Individual
Prefix:
First Name:ALEENA
Middle Name:
Last Name:SHROPSHIRE
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 1:1348 W BENJAMIN RD NW
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:OH
Mailing Address - Zip Code:43758-9484
Mailing Address - Country:US
Mailing Address - Phone:220-203-5386
Mailing Address - Fax:
Practice Address - Street 1:1348 W BENJAMIN RD NW
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:OH
Practice Address - Zip Code:43758-9484
Practice Address - Country:US
Practice Address - Phone:220-203-5386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUD396822374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide