Healthcare Provider Details

I. General information

NPI: 1396592234
Provider Name (Legal Business Name): SHANNON SZWEB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2135 EVERGREEN RD
COVINGTON VA
24426-6120
US

IV. Provider business mailing address

2135 EVERGREEN RD
COVINGTON VA
24426-6120
US

V. Phone/Fax

Practice location:
  • Phone: 951-539-8943
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
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: