Healthcare Provider Details

I. General information

NPI: 1538094271
Provider Name (Legal Business Name): SHALONDA DENISE BENNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 WILTON FARM RD APT 202
CHARLOTTESVILLE VA
22911-7617
US

IV. Provider business mailing address

1410 WILTON FARM RD APT 202
CHARLOTTESVILLE VA
22911-7617
US

V. Phone/Fax

Practice location:
  • Phone: 910-605-6731
  • Fax:
Mailing address:
  • Phone: 910-605-6731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
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: