Healthcare Provider Details

I. General information

NPI: 1427871151
Provider Name (Legal Business Name): SHIRLEY ANN KOWALSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 11/03/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19272 BRIARWOOD LN
STRONGSVILLE OH
44149-3109
US

IV. Provider business mailing address

19272 BRIARWOOD LN
STRONGSVILLE OH
44149-3109
US

V. Phone/Fax

Practice location:
  • Phone: 440-785-9483
  • Fax:
Mailing address:
  • Phone: 440-785-9483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: