Provider Demographics
NPI:1912437328
Name:ZERVAS, SHEALYN L
Entity type:Individual
Prefix:
First Name:SHEALYN
Middle Name:L
Last Name:ZERVAS
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 1:3954 S SWANSON CT
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-4072
Mailing Address - Country:US
Mailing Address - Phone:616-581-4397
Mailing Address - Fax:
Practice Address - Street 1:3954 S SWANSON CT
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-4072
Practice Address - Country:US
Practice Address - Phone:616-581-4397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant