Provider Demographics
NPI:1962009456
Name:RONEY, SHAWN MICHELLE (INDEPENDENT PROVIDER)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:MICHELLE
Last Name:RONEY
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:MRS
Other - First Name:SHAWN
Other - Middle Name:MICHELLE
Other - Last Name:SHAUVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SHAWN
Mailing Address - Street 1:10827 RAVENNA RD APT 105
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1077
Mailing Address - Country:US
Mailing Address - Phone:971-285-7727
Mailing Address - Fax:
Practice Address - Street 1:10827 RAVENNA RD APT 105
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-1077
Practice Address - Country:US
Practice Address - Phone:971-285-7727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No251X00000XAgenciesSupports Brokerage
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0402347Medicaid