Healthcare Provider Details

I. General information

NPI: 1174450829
Provider Name (Legal Business Name): KEISHAWN SHOWERS S.2504778-TRNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N E ST
HAMILTON OH
45013-3048
US

IV. Provider business mailing address

2779 CLEVELAND BLVD
LORAIN OH
44052-2409
US

V. Phone/Fax

Practice location:
  • Phone: 614-407-4590
  • Fax:
Mailing address:
  • Phone: 614-407-4590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2504778-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: