Provider Demographics
NPI:1982405387
Name:DEVINE, SHONDA L
Entity type:Individual
Prefix:MRS
First Name:SHONDA
Middle Name:L
Last Name:DEVINE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15385 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44427-9706
Mailing Address - Country:US
Mailing Address - Phone:234-567-0156
Mailing Address - Fax:
Practice Address - Street 1:15385 SMITH RD
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:OH
Practice Address - Zip Code:44427-9706
Practice Address - Country:US
Practice Address - Phone:234-567-0156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No374U00000XNursing Service Related ProvidersHome Health Aide