Healthcare Provider Details

I. General information

NPI: 1679016091
Provider Name (Legal Business Name): SHANIQUIE GREER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2016
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15009 LAWNDALE AVE
CLEVELAND OH
44128-3030
US

IV. Provider business mailing address

15009 LAWNDALE AVE
CLEVELAND OH
44128-3030
US

V. Phone/Fax

Practice location:
  • Phone: 440-370-0826
  • Fax:
Mailing address:
  • Phone: 440-370-0826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberTF169802
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number602373631121
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: