Provider Demographics
NPI:1992537732
Name:FRUMP, SHAWNA LYNNE
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:LYNNE
Last Name:FRUMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:LYNNE
Other - Last Name:FRUMP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:MOWRYSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45155-0028
Mailing Address - Country:US
Mailing Address - Phone:937-509-3532
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 34
Practice Address - Street 2:
Practice Address - City:MOWRYSTOWN
Practice Address - State:OH
Practice Address - Zip Code:45155-0034
Practice Address - Country:US
Practice Address - Phone:937-205-2775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty