Healthcare Provider Details

I. General information

NPI: 1699630194
Provider Name (Legal Business Name): SHANTELLE LAUGHLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8342 NEILSTON CROSSING DR
COLUMBUS OH
43081-8726
US

IV. Provider business mailing address

8342 NEILSTON CROSSING DR
COLUMBUS OH
43081-8726
US

V. Phone/Fax

Practice location:
  • Phone: 870-818-5060
  • Fax:
Mailing address:
  • Phone: 870-818-5060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: